Abstract
Objective
To estimate treatment effect size of a peer-led Wheelchair Self-Efficacy Enhanced
for Use (WheelSeeU) program on objective wheelchair skills (primary); and on perceived
wheelchair skills capacity and performance, wheelchair use self-efficacy, satisfaction
with participation, life-space mobility, and participation frequency (secondary);
and to evaluate retention 6 months later (secondary).
Design
Randomized controlled trial.
Setting
Rehabilitation centers and communities.
Participants
Community-living older adults (N=40).
Intervention
WheelSeeU comprised six 90-minute peer-led sessions of customized training (in pairs)
according to participants’ goals. A support-trainer provided spotting. The control
group comprised six 90-minute professional-led didactic information sessions (in pairs).
Main Outcome Measures
The Wheelchair Skills Test (WST), Wheelchair Skills Test Questionnaire (WST-Q), Wheelchair
Use Confidence Scale for Manual Wheelchair Users-Short Form (WheelCon-M-SF), Wheelchair
Outcomes Measure (WhOM), Life-Space Mobility (LSA), and Late Life Function and Disability
Index (LLFDI) were collected at baseline (T1), postintervention (T2), and 6 months
postintervention (T3).
Results
Of 121 screened, 39 individuals did not meet the inclusion criteria and 41 declined
to participate. Forty participants (64.5 years of age; 60% men) were randomized, 38
completed the intervention, and 35 completed T3 assessments. There were no adverse
effects. WheelSeeU did not have a statistically significant greater effect on objective
WST (primary) or WST-Q capacity, WheelCon, LSA, and LLFDI at T2 compared to the control
group. Effect sizes were statistically significant and large for WST-Q performance
(Cohen’s d=0.72) and the WhOM (Cohen’s d=0.82) at T2, and effects were retained at
T3.
Conclusion
Compared to an active control group, WheelSeeU did not have a greater effect on wheelchair
skills capacity. However, WheelSeeU should not be prematurely dismissed as an approach
to potentially improve wheelchair skills performance and satisfaction with participation
in meaningful activities. Sex and depression are important when designing interventions
for older adults.
Keywords
List of abbreviations:
ICF (International Classification of Functioning, Disability, and Health), iWheel (Resources for Improving Wheelchair Use), LLFDI (Late Life Function and Disability Index), LSA (Life-Space Assessment), MWC (manual wheelchair), RCT (randomized controlled trial), WheelCon-M-SF (Wheelchair Use Confidence Scale for Manual Wheelchair Users-Short Form), WheelSeeU (Wheelchair Self-Efficacy Enhanced for Use), WhOM (Wheelchair Outcome Measure), WST (Wheelchair Skills Test version 4.1), WST-Q (Wheelchair Skills Test Questionnaire)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 23, 2018
Footnotes
Supported by the Canadian Institutes for Health Research (grant no. MOP-125953).
Clinical Trial Registration No.: NCT01838135.
Disclosures: Dr. Krista Best received salary support from the Quebec Health Research Funds (FRQS) and the Craig H. Neilsen Foundation. Dr. François Routhier received salary support from the FRQS Research Scholar Award. The other authors report nothing to disclose.
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
