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Volume 90, Issue 10, Pages 1680-1684 (October 2009)


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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.

R. Lee Kirby, MD, FRCPCaCorresponding Author Informationemail address, Rebecca Walker, MScPTb, Cher Smith, BSc (OT)d, Krista Best, MScb, Donald A. MacLeod, MSce, Kara Thompson, MScc

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.

a Division of Physical Medicine and Rehabilitation, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada

b School of Health and Human Performance, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada

c Department of Medicine, Dalhousie University, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada

d Department of Occupational Therapy, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada

e Clinical Locomotor Function Laboratory, Queen Elizabeth II Health Sciences Centre, Nova Scotia Rehabilitation Centre Site, Halifax, Nova Scotia, Canada

Corresponding Author InformationCorrespondence 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).

 Clinical trials registration number: CDHA013; clinical trials ID: NCT00377533.

 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.

 Reprints are not available from the author.

PII: S0003-9993(09)00378-5

doi:10.1016/j.apmr.2009.04.013


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