Abstract
Kirby RL, Mifflen NJ, Thibault DL, Smith C, Best KL, Thompson KJ, MacLeod DA. The
manual wheelchair-handling skills of caregivers and the effect of training.
Objective
To test the hypothesis that the Wheelchair Skills Training Program (WSTP) is effective
in improving the wheelchair-handling skills of untrained caregivers.
Design
Within-participant comparisons.
Setting
Rehabilitation center and community.
Participants
Twenty-four caregivers of manual wheelchair users.
Interventions
Caregiver participants underwent the WSTP, version 2.4, adapted for caregivers. Training
was individualized on the basis of an integrated testing-and-training protocol that
took place on a single occasion (total, ≈50min).
Main outcome measures
Total percentage scores on the objective Wheelchair Skills Test (WST), version 2.4,
for the pretraining (N=24), posttraining (N=24), and retention (n=9) evaluations.
For the skill-transfer evaluation (n=10), we used the questionnaire version (WST-Q),
administered by telephone to participants after return to their communities.
Results
There were no serious adverse incidents. The mean pretraining total WST score ± standard
deviation was 77.8%±12.0%. Posttraining, this increased to 94.7%±7.1% (P<.001), a 22% relative increase. At retention testing, a median latency of 7 days
later, the mean value, 94.2%±7.1%, did not decrease significantly from the posttraining
level (P=.38). At skill-transfer testing, a median latency of 179 days posttraining, the mean
value, 92.5%±8.7%, did not decrease significantly from the posttraining level (P=.73). The greatest improvements were at the advanced skill level.
Conclusions
The WSTP is a safe, practical, and effective method of improving the wheelchair-handling
skills of untrained caregivers. Skill improvements are generally well retained and
transfer well to the community. Such training could play an important role in the
rehabilitation process.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Assistance arrangements and use of services among people with multiple sclerosis and their caregivers.Disabil Rehabil. 1996; 18: 354-361
- Time of care required by patients discharged from a rehabilitation unit.Am J Phys Med Rehabil. 2002; 81: 57-62
- Psychiatric and physical morbidity effects of caregiving.J Gerontol. 1990; 45: 181-191
- Client centered approach to develop a seating clinic satisfaction questionnaire.Am J Occup Ther. 1995; 49: 980-985
- Impact of wheeled seated mobility devices on adult users’ and their caregivers’ occupational performance.Can J Occup Ther. 2002; 69: 261-280
- Relatives of the impaired elderly.Gerontologist. 1980; 20: 649-655
- Subjective burden of husbands and wives as caregivers.Gerontologist. 1986; 26: 260-266
- Gender differences in mental and physical illness.Soc Sci Med. 1984; 19: 77-91
- Home or hospital or stroke rehabilitation? Results of a randomized controlled trial: I: Health outcomes at 6 months.Stroke. 2000; 31: 1024-1031
- A two-factor model of caregiving appraisal and psychological well-being.J Gerontol. 1991; 46: 181-189
- Vulnerability of husband and wife caregivers of Alzheimer disease patients to caregiving stressors.Alzheimer Dis Assoc Dis. 2001; 15: 201-210
- People with mobility impairments in the United States today and in 2010.Assist Technol. 1996; 8: 43-53
- Fatal wheelchair-related accidents in the United States.Am J Phys Med Rehabil. 1990; 69: 184-190
- Nonfatal wheelchair-related accidents reported to the National Electronic Injury Surveillance System.Am J Phys Med Rehabil. 1994; 73: 163-167
- Shoulder imaging abnormalities in individuals with paraplegia.J Rehabil Res Dev. 2001; 38: 401-408
- Wheelchair rider injuries.J Rehabil Res Dev. 1997; 34: 58-71
- Ergonomics of folding and unfolding a manual wheelchair.Appl Ergon. 2003; 34: 571-579
- Ergonomics in rehabilitation.Arch Phys Med Rehabil. 1998; 79: 955-958
- Practical problems and management of seating through the clinical stages of Duchenne’s muscular dystrophy.Arch Phys Med Rehabil. 2003; 84: 818-824
- Wheelchair accessibility—living the experience.Occup Ther J Res. 1998; 18: 25-43
- Barriers to access.Rehabil Nurs. 1998; 23: 120-125
Americans with Disabilities Act (ADA) of 1990. Accessibility Guidelines for Buildings and Facilities (ADAAG). 56 Federal Register 35408-542 (1991).
- Factors of significance for mobility in children with myelomingocele.Acta Pediatr. 2003; 92: 204-210
- Quality of life among persons with multiple sclerosis and their caregivers.Neurology. 1997; 48: 74-80
- Effect of environmental setting on mobility methods of children with cerebral palsy.Dev Med Child Neurol. 2003; 45: 113-120
- Evaluation of training in patient handling and moving skills among hospital and home care personnel.Ergonomics. 2002; 45: 850-865
- Wheelchair Skills Training Program.Arch Phys Med Rehabil. 2004; 85: 41-50
- Wheelchair Skills Training Program for clinicians.Arch Phys Med Rehabil. 2004; 85: 1160-1167
Kirby RL, Thibault D, Mifflin N, Smith C, MacLeod DA. Manual wheelchair-handling skills of caregivers: effect of a wheelchair skills training program. Paper presented at: The RESNA 26th International Conference; 2003 June 21; Atlanta (GA).
- The Wheelchair Skills Test (version 2.4).Arch Phys Med Rehabil. 2004; 85: 794-804
- Functional impact of a rigid pelvic stabilizer on children with cerebral palsy who use wheelchairs.Pediatr Rehabil. 1999; 3: 101-118
- Effects of a wheelchair-mounted rigid pelvic stabilizer on caregiver assistance for children with cerebral palsy.Assist Technol. 2001; 13: 2-11
- The Wheelchair Skills Test.Arch Phys Med Rehabil. 2002; 83: 10-18
- Evaluation of manual wheelchair skills.Arch Phys Med Rehabil. 2002; 83: 1295-1299
- The Wheelchair Skills Test, version 2.4.Arch Phys Med Rehabil. 2004; 85: 416-423
- Learning to perform wheelchair wheelies.Arch Phys Med Rehabil. 2004; 85: 785-793
- Using a wheelchair activity as a learning experience for student nurses.Rehabil Nurs. 1995; 20 (273.): 265-267
- Consolidation in human motor memory.Nature. 1996; 382: 252-255
- From primed to learn.Cogn Brain Res. 2002; 13: 313-322
- Enhancing training efficiency and effectiveness through the use of dyad training.J Mot Behav. 1999; 31 (199-125)
- A dyadic protocol for training complex skills.Hum Factors. 1992; 34: 369-374
- Effect of push handle height on net moments and forces on the musculoskeletal system during standardized wheelchair pushing tasks.Prosthet Orthot Int. 1995; 19: 188-201
- The design of attendant propelled wheelchairs.Prosthet Orthot Int. 1991; 15: 38-45
Article info
Footnotes
Supported by the Canadian Institutes of Health Research and the Capital District Health Authority Research Fund.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated.
Identification
Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
