Wheelchair Skills Training for Community-Based Manual Wheelchair Users: A Randomized Controlled Trial

Abstract 

Best KL, Kirby RL, Smith C, MacLeod DA. Wheelchair skills training for community-based manual wheelchair users: a randomized controlled trial.

Objective

To test the hypotheses that wheelchair skills training of community-based manual wheelchair users is efficacious, safe, and practical.

Design

Randomized controlled trial.

Setting

Rehabilitation center and community.

Participants

Twenty community-based manual wheelchair users (15 men, 5 women; age range, 21–77y), half with musculoskeletal and half with neurologic disorders.

Intervention

Participants were randomly allocated to the Wheelchair Skills Training Program (WSTP) or control groups. In 1-hour individualized sessions, the WSTP group participants received a mean ± standard deviation of 4.5±0.7 hours of training. Caregivers participated whenever possible. In addition to training at the rehabilitation center, the trainer traveled to administer training in the community.

Main Outcome Measures

Using the Wheelchair Skills Test (WST, version 3.1), an objective test of 57 skills, we calculated total and subtotal percentage scores (percentage number of skills passed of those possible) and individual skill success rates.

Results

The WSTP group’s improvement in total WST score was significantly greater than the control group’s (P<.005). The mean total WST score for the WSTP group increased from a pretraining value of 63.3%±6.0% to 78.5%±8.3% posttraining, a relative improvement of 24.0% (P=.002). The control group increased from a baseline value of 70.8%±14.0% to 74.2%±11.8% at follow-up, a relative improvement of 4.8% (P=.03). The WSTP group had clinically significant pre- and posttraining improvements (≥20%) in the success rates of 25 of the 57 individual WST skills, compared with only 5 skills for the control group. There were no adverse incidents, and the WSTP participants’ comments were all positive.

Conclusions

Wheelchair skills training of community-based manual wheelchair users is efficacious, safe, and practical. These findings have implications for the standard of rehabilitation care.

Key Words:  Caregivers , Motor skills , Rehabilitation , Wheelchairs