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Fasipe G, Goršič M, Rahman MH, Rammer J. Community mobility and participation assessment of manual wheelchair users: a review of current techniques and challenges. Front Hum Neurosci 2024; 17:1331395. [PMID: 38249574 PMCID: PMC10796510 DOI: 10.3389/fnhum.2023.1331395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
According to the World Health Organization, hundreds of individuals commence wheelchair use daily, often due to an injury such as spinal cord injury or through a condition such as a stroke. However, manual wheelchair users typically experience reductions in individual community mobility and participation. In this review, articles from 2017 to 2023 were reviewed to identify means of measuring community mobility and participation of manual wheelchair users, factors that can impact these aspects, and current rehabilitation techniques for improving them. The selected articles document current best practices utilizing self-surveys, in-clinic assessments, and remote tracking through GPS and accelerometer data, which rehabilitation specialists can apply to track their patients' community mobility and participation accurately. Furthermore, rehabilitation methods such as wheelchair training programs, brain-computer interface triggered functional electric stimulation therapy, and community-based rehabilitation programs show potential to improve the community mobility and participation of manual wheelchair users. Recommendations were made to highlight potential avenues for future research.
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Affiliation(s)
- Grace Fasipe
- Department of Biomedical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Maja Goršič
- Department of Biomedical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Mohammad Habibur Rahman
- Department of Biomedical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
- Department of Mechanical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Jacob Rammer
- Department of Biomedical Engineering, College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Seemüller S, Beck F, Reimers AK. Physical activity of children and adolescents who use a wheelchair: a systematic review. BMC Public Health 2023; 23:2479. [PMID: 38082282 PMCID: PMC10714460 DOI: 10.1186/s12889-023-17201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023] Open
Abstract
Physical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote physical activity among children and adolescents who use a wheelchair as their primary source of mobility, this systematic review explores the physical activity patterns of this group. A systematic search of PubMed, Sports Medicine & Education Index, Web of Science, and SPORTDiscus was performed, included articles were synthesized in terms of duration, intensity, and settings in which physical activity occurred, as well as the physical activity measurement methods. Nine articles were included. The mean overall physical activity level across the included studies was 98 minutes per day (range: 78-115 minutes per day). Two articles analysed the duration of physical activity at different intensities (very light physical activity, light physical activity (LPA), moderate to vigorous physical activity (MVPA) and intensities near to maximum). Within the included articles, both subjective and objective measurement methods were used. Due to the small number of articles, combined with small sample sizes, there is not enough evidence to answer the research questions sufficiently. Nevertheless, the review provides an overview of actual research and clearly shows that the physical activity values are insufficiently researched. There is a need for further research on the scope, types and settings of physical activity in the target group.
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Affiliation(s)
- Selina Seemüller
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Franziska Beck
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anne Kerstin Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Pituch E, Rushton PW, Culley K, Houde M, Lahoud A, Lettre J, Routhier F. Exploration of pediatric manual wheelchair confidence among children, parents, and occupational therapists: a qualitative study. Disabil Rehabil Assist Technol 2023; 18:1229-1236. [PMID: 34806519 DOI: 10.1080/17483107.2021.2001059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Manual wheelchair (MWC) confidence is a predictor of adult life-space mobility and social participation. To date, scientific literature specific to pediatric MWC confidence is scarce which prevents in-depth understanding. The objective of this study was to explore the perceptions of pediatric MWC users (PMWU), parents, and occupational therapists regarding pediatric MWC confidence. METHODS Five focus groups were conducted with PMWUs (n = 12) and occupational therapists (n = 9), and semi-structured interviews were conducted with parents of PMWUs (n = 2). Inductive thematic analysis was performed following verbatim transcription of audio recorded material. RESULTS Three overarching themes were identified across PMWUs, parents, and occupational therapists: (1) "MWC confidence is not a clinical priority" depicted the construct's varying level of clinical priority and perceived abstractness; (2) "MWC confidence is both a child and parent consideration" revealed nuances between the PMWU's MWC confidence and the parents' perception of the PMWU's MWC confidence; and (3) "Opportunities to develop MWC confidence are context-specific" contrasted afforded and unafforded opportunities to experience independent MWC mobility. CONCLUSIONS Pediatric MWC confidence is an important aspect of wheelchair use that is shaped by a multitude of factors in PMWU's lives. This new area of pediatric study provides support for the need to measure this important construct.IMPLICATIONS FOR REHABILITATIONThis study is the first to explore children's, parents', and occupational therapists' perceptions of pediatric MWC confidence.Pediatric MWC confidence impacts MWC use in a multifaceted fashion.Future studies should consider the development and validation of a self-report measure to assess pediatric MWC confidence.
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Affiliation(s)
- Evelina Pituch
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Paula W Rushton
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Kim Culley
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Martine Houde
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Alexandra Lahoud
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Josiane Lettre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
- Department of Rehabilitation, Université Laval, Quebec City, Canada
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Ouellet B, Best KL, Wilson D, Miller WC. Exploring the Influence of a Community-Based Peer-Led Wheelchair Skills Training on Satisfaction with Participation in Children and Adolescents with Cerebral Palsy and Spina Bifida: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11908. [PMID: 36231211 PMCID: PMC9564843 DOI: 10.3390/ijerph191911908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Peer-led approaches improve satisfaction with participation, wheelchair skills and wheelchair use self-efficacy in adults, but the evidence is limited in children. This pilot study aimed to explore the influence of community-based, peer-led, group wheelchair training program (i.e., Seating To Go) on satisfaction with participation (primary outcome), wheelchair skills, and wheelchair use self-efficacy in children and adolescents with cerebral palsy and spina bifida. METHODS A single group pre-post design was used. Invitations were shared online and diffused by clinicians and advocacy and provider groups to recruit a convenience sample of eight pediatric wheelchair users. Participants completed the Seating To Go program in groups that were facilitated by adult wheelchair users. Satisfaction with participation (Wheelchair Outcome Measure-Young People), wheelchair skills (Wheelchair Skills Test), wheelchair use self-efficacy (Wheelchair Use Confidence Scale), and perceived wheelchair skills capacity (Wheelchair Skills Test Questionnaire; proxy rating: parents) were evaluated before and after the Seating To Go program. Descriptive statistics and nonparametric longitudinal data analysis were conducted to explore changes in all outcomes from baseline to post-intervention. RESULTS Pediatric wheelchair users (ranging in age from 5 to 15 years) and their parents reported statistically significant improvements in satisfaction with participation. The improvements in wheelchair skills and wheelchair confidence were also statistically significant, but not the parents' perception of their children's wheelchair skills. CONCLUSIONS A community-based peer-led approach to wheelchair skills training seems promising for improving wheelchair outcomes in pediatric wheelchair users. Further controlled studies with larger samples are warranted.
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Krista L. Best
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Deb Wilson
- Seating To Go—Geneva Healthcare, Hamilton 3204, New Zealand
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- G.F. Strong Rehabilitation Centre—Rehabilitation Research Lab, Vancouver, BC V5Z 2G9, Canada
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Kenyon LK, Hesse EN, Pakkala KJ, Vanderest S. Outcomes of a child-based manual wheelchair skills peer training program: an exploratory case report. Disabil Rehabil Assist Technol 2021; 18:1-5. [PMID: 34048664 DOI: 10.1080/17483107.2021.1931966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/10/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this exploratory case series was to describe the outcomes for both a child-learner and a child-peer after a single manual wheelchair (MWC) skills training session involving child-based peer training techniques, followed by related home-based skills practice. MATERIALS AND METHODS Participants were a 9-year-old with L4-L5 spina bifida (pseudonym: Amari) and a 3-year-old with T10 spina bifida (pseudonym: Mary). Pre-intervention examination included administration of the Wheelchair Skills Test Questionnaire (WST-Q), the MWC short scale within the Mobility domain of the Paediatric Evaluation of Disability - Computer Adapted Test (MWC PEDI-CAT), and the Canadian Occupational Performance Measure (COPM). The peer training session, facilitated by a physical therapy team, involved games and activities involving MWC use. When appropriate, Amari was asked to talk aloud and verbally describe the components of the skills she was performing. Each child and her mother were instructed in specific MWC skills to practice at home over a 3-week period. RESULTS Both participants' post-intervention WST-Q capacity, confidence, and performance scores increased. Increases in parent-proxy COPM scores indicated clinically meaningful change in all identified occupational performance problems. Mary's total MWC PEDI-CAT post-intervention score increased by 11 points. Both mothers reported that the participation in the activities helped also to improve their child's self-esteem and self-image. CONCLUSIONS Both the participants in this exploratory case appeared to demonstrate improvements in MWC skills, self-esteem, and self-image following a single child-based MWC skills peer training session and related home-based skills practice. Future research involving such peer training methods is warranted.
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Affiliation(s)
- Lisa K Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Elizabeth N Hesse
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Katelynn J Pakkala
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
| | - Sebastian Vanderest
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
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Sol ME, Verschuren O, Horemans H, Westers P, Visser-Meily JMA, De Groot JF. The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair. Disabil Rehabil 2021; 44:4398-4407. [PMID: 33874820 DOI: 10.1080/09638288.2021.1907456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. METHODS Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. RESULTS Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. CONCLUSIONS A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
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Affiliation(s)
- Marleen E Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Henricus Horemans
- Department of Rehabilitation Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Paul Westers
- Department of Biostatistics and Research Support, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Janke F De Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
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