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Effectiveness of Group Wheelchair Maintenance Training for People with Spinal Cord Injury: A Randomized Controlled Trial

      Abstract

      Objective

      To assess the effectiveness of group wheelchair maintenance training and investigate participant characteristics associated with responsiveness to training.

      Design

      Randomized controlled trial with an immediate group and a waitlist control group (WLCG) who received the intervention after a 6-month delay.

      Setting

      Four Spinal Cord Injury Model Systems Centers.

      Participants

      Manual (MWC; n=80) and power wheelchair (PWC; n=67) users with spinal cord injury (N=147).

      Interventions

      Two 90-minute structured wheelchair maintenance training program classes with 12-20 people per class and separate classes for MWC and PWC users. Each class included in-person hands-on demonstrations and practice of wheelchair maintenance.

      Main Outcome Measures

      Separate analysis was completed for MWC and PWC users using the Wheelchair Maintenance Training Questionnaire (WMT-Q) capacity (ability to complete), performance (frequency of completion) and knowledge at baseline, 1 month, 6 months, 6 months pretraining (WLCG only), and 1 year (immediate only).

      Results

      After the intervention, participants in both the immediate and WLCG improved in maintenance capacity (MWC and PWC, P<.001) and performance (MWC and PWC, P<.001) with training. Only PWC users improved knowledge of wheelchair maintenance (P<.001). For both WLCGs (MWC and PWC), there was no difference between the 6-month pretraining time point and baseline. MWC users who responded to training had lower WMT-Q scores for all domains, whereas this was only the case for knowledge for PWC users.

      Conclusions

      Group wheelchair skills training is effective at improving capacity to complete maintenance and performance of maintenance activities for MWC and PWC users, even in a cohort of experienced wheelchair users. For MWC users, improvements were tied to lower WMT-Q scores at baseline, whereas PWC users improved in capacity and performance independent of baseline score. Delivering this training in a structured group format has a lower cost, which might improve adoption into clinical practice.

      Keywords

      List of abbreviations:

      CI (confidence interval), MWC (manual wheelchair), PWC (power wheelchair), SCI (spinal cord injury), WLCG (wait list control group), WMT-Q (Wheelchair Maintenance Training Questionnaire)
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