Manual Wheelchair-Handling Skills by Caregivers Using New and Conventional Rear Anti-Tip Devices: A Randomized Controlled Trial
Presented in part to the American Academy of Physical Medicine and Rehabilitation, September 27–30, 2007, Boston, MA.
Abstract
Kirby RL, Walker R, Smith C, Best K, MacLeod DA, Thompson K. Manual wheelchair-handling skills by caregivers using new and conventional rear anti-tip devices: a randomized controlled trial.
Objective
To test the hypothesis that, in comparison with caregivers handling manual wheelchairs equipped with conventional rear anti-tip devices (C-RADs), those using a new design (Arc-RADs) perform relevant wheelchair skills better and as safely.
Design
Randomized controlled trial.
Setting
Rehabilitation center.
Participants
Caregivers (n=16) and the wheelchair users (n=16) for whom they cared.
Intervention
Participants were trained in wheelchair-handling skills for an average of 54 minutes each.
Main Outcome Measures
Total percentage score on a set of 20 rear anti-tip device- and caregiver-relevant skills from the Wheelchair Skills Test, version 3.2, administered a minimum of 3 days after training.
Results
For the C-RAD and Arc-RAD groups, the mean ± SD Wheelchair Skills Test scores were 40%±0% and 98.8%±3.5%, respectively (P<.001). Skills that required the wheelchair to be tipped back extensively (eg, for ascending a 15cm curb) accounted for the differences between the groups. There were no adverse effects in either group.
Conclusions
The Arc-RAD design allows significantly better caregiver wheelchair-handling skills than the conventional design, without compromising safety.
aDivision of Physical Medicine and Rehabilitation, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada
bSchool of Health and Human Performance, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada
cDepartment of Medicine, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada
dDepartment of Occupational Therapy, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada
eClinical Locomotor Function Laboratory, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada
Correspondence to R. Lee Kirby, MD, FRCPC, Division of Physical Medicine and Rehabilitation, Dept of Medicine, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Rehabilitation Centre Site, Halifax, Nova Scotia, Canada
This study was funded by the Canadian Institutes of Health Research (grant no. 2004021TG-126560-DAI-CHAA-13681).
Kirby holds a U.S. patent on the device that is the focus of this study. There are plans to commercialize the device. We certify that no other party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated.