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Pilot Study of a Peer-Led Wheelchair Training Program to Improve Self-Efficacy Using a Manual Wheelchair: A Randomized Controlled Trial

  • Krista L. Best
    Affiliations
    Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Rehabilitation Research Program, Vancouver Coastal Research Institute, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
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  • William C. Miller
    Correspondence
    Corresponding author William C. Miller, PhD, FCAOT, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, T325 - 2211 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 2B5.
    Affiliations
    Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Rehabilitation Research Program, Vancouver Coastal Research Institute, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada

    Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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  • Grant Huston
    Affiliations
    Rehabilitation Research Program, Vancouver Coastal Research Institute, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
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  • Francois Routhier
    Affiliations
    Department of Rehabilitation, Université Laval, Quebec City, Quebec, Canada

    Center for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec, Quebec City, Quebec, Canada
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  • Janice J. Eng
    Affiliations
    Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Rehabilitation Research Program, Vancouver Coastal Research Institute, GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada

    Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Published:September 03, 2015DOI:https://doi.org/10.1016/j.apmr.2015.08.425

      Abstract

      Objectives

      To evaluate the effect of a peer-led wheelchair training program on self-efficacy of manual wheelchair (MWC) use and to explore influences of the intervention on MWC skills, life-space mobility, and satisfaction with participation.

      Design

      Pilot randomized controlled trial.

      Setting

      Rehabilitation center and community.

      Participants

      Community-living MWC users (N=28; mean MWC experience, 13y; mean age, 49y; 6 [21%] women).

      Interventions

      The experimental group (n=16) received six 1.5-hour sessions of a peer-led self-efficacy–enhanced wheelchair training program (WheelSee). On the basis of individualized goals, peer trainers administered WheelSee to pairs of MWC users. The control group (n=12) received no intervention.

      Main Outcome Measures

      The primary outcome—wheelchair use self-efficacy—was assessed using the Wheelchair Use Confidence Scale (WheelCon) version 3.0. Secondary outcomes included wheelchair skills capacity and performance (Wheelchair Skills Test Questionnaire version 4.1), life-space mobility (Life Space Assessment), and satisfaction with participation (Wheelchair Outcome Measure).

      Results

      Controlling for baseline scores, an analysis of covariance revealed that WheelSee had a large statistically significant effect on MWC use self-efficacy in community-living adult MWC users (Cohen d=1.4; P=.002) than in a control group. WheelSee also had a large statistically significant effect on MWC skills capacity (Cohen d=1.3; P=.003) and performance (Cohen d=1.0; P=.02). There were no statistically significant differences in life-space mobility or satisfaction with participation scores between the groups.

      Conclusions

      A peer-led MWC training program improves wheelchair use self-efficacy in adult MWC users and had a positive influence on other wheelchair-related outcomes. WheelSee may offer a promising intervention strategy to accommodate the training needs of community-living MWC users.

      Keywords

      List of abbreviations:

      CI (confidence interval), MWC (manual wheelchair), WheelCon (Wheelchair Use Confidence Scale), WheelSee (self-efficacy--enhanced wheelchair training program), WhOM (Wheelchair Outcome Measure), WST-Q (Wheelchair Skills Test Questionnaire)
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