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Chase T, Mendoza K, Rager C, Stiens M, Loeser M, Stead T, Kozlowski W, Van Antwerp L, Camilleri J, O'Neil J. Skills on wheels: initial pre-post findings from a pilot study of a pediatric wheelchair skills training program. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38436131 DOI: 10.1080/17483107.2024.2324146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
Skills on Wheels, a 5-week pediatric wheelchair skills training program implemented over 2 years, was developed to address confidence, social participation, and mobility for wheelchair-using children. This study tests the hypothesis that pediatric wheelchair skills training will increase wheelchair skill ability, confidence, and participation of wheelchair-using children. Individualized instruction was delivered by occupational (N = 50) and physical (N = 12) therapy practitioners and doctoral students. The primary program intervention was adapted for pediatric wheelchair users from the adult Wheelchair Skills Training Program, developed by Dalhousie University, consisting of a total of 33 wheelchair skills. An adapted version of the Wheelchair Confidence measure (Wheel-Con-M-P), the Participation and Environment Measure for Children and Youth (PEM-CY), and Wheelchair Skills Test (WST) were used to measure participants confidence and ability to complete wheelchair skills, endurance, and participation and satisfaction in community, school, and home. The study resulted in: increases in confidence in ability to move wheelchair over threshold (+1.00, p < 0.05), ability to carry lunchbox/bookbag (+0.65, p < 0.05), ability to move in wheelchair when worried or scared (+1.3, p < 0.05), ability to ask for help, and ability to say "no" if they don't need help (+0.58, p < 0.05) were indicated. The WST indicated increased ability (p < 0.05) on several skills. The Fear of Falling Measure found an overall decrease in fear of falling (-2.37, p < 0.01). The Skills on Wheels program demonstrated many successes in this initial 2-year study and data suggest a positive trend for iterations to come.
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Affiliation(s)
- Tony Chase
- Department of Occupational Therapy, Indiana University, Indianapolis, IN, USA
| | - Kiera Mendoza
- Department of Occupational Therapy, Indiana University, Indianapolis, IN, USA
| | - Carson Rager
- Department of Occupational Therapy, Indiana University, Indianapolis, IN, USA
| | - Maria Stiens
- Department of Occupational Therapy, Indiana University, Indianapolis, IN, USA
| | - Madison Loeser
- Department of Occupational Therapy, Indiana University, Indianapolis, IN, USA
| | - Tiffany Stead
- Indiana University Health - Rehabilitation Services, Riley Hospital for Children, Indianapolis, IN, USA
| | - Whitney Kozlowski
- Indiana University Health - Rehabilitation Services, Riley Hospital for Children, Indianapolis, IN, USA
| | - Leah Van Antwerp
- Department of Occupational Therapy, Indiana University, Indianapolis, IN, USA
| | - Jessica Camilleri
- Indiana University Health - Pediatric Physical Medicine and Rehabilitation, Riley Hospital for Children, Indianapolis, IN, USA
| | - Joseph O'Neil
- Indiana University School of Medicine - Department of Developmental Pediatrics, Indianapolis, IN, USA
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Ouellet B, Berthiaume J, Fortin C, Rusu MT, Rushton PW, Dib T, Routhier F, Best KL. User perceptions about resources based on the Wheelchair Skills Training Program for training indoor and community wheelchair skills in pediatrics: a descriptive qualitative study. Disabil Rehabil Assist Technol 2024:1-14. [PMID: 38214481 DOI: 10.1080/17483107.2024.2303464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE The Wheelchair Skills Training Program (WSTP) is underutilized in pediatrics for training manual wheelchair skills because the voluminous manual lacks pediatric specificity and no materials adapted for pediatric manual wheelchair users (PMWUs) are available. A set of resources (storybook, posters, training workbook) based on the WSTP has previously been developed for training basic indoor wheelchair skills with five to 15-year-old PMWUs. Occupational therapists (OTs) and PMWUs expressed a need for additional resources addressing higher-level skills. Two new sets of resources teaching indoor and community wheelchair skills were developed. OBJECTIVE Describe OTs' and PMWUs' satisfaction and perceptions regarding usability, relevance and feasibility in pediatrics with the new resources. METHODS A descriptive qualitative study was conducted. A focus group and interviews were respectively conducted with a convenience sample of OTs and a criterion sample of PMWUs to document perceptions regarding satisfaction, usability, relevance and feasibility. A deductive approach to data analyses was used following the Framework Method. RESULTS Six OTs expressed satisfaction regarding both sets of resources feeling more confident using the WSTP (relevance) and perceiving potential time efficiencies when planning training interventions (feasibility). They provided suggestions to improve the usability of the second set. Six PMWUs participated in the interviews, two of which provided feedback on both sets. They were satisfied with the resources recommending them to novice and temporary PMWUs aged from three to 11 years. CONCLUSION Participants' suggested the resources may contribute to reducing the gap between the evidence supporting the WSTP and its utilization in pediatrics.
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Affiliation(s)
- Béatrice Ouellet
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Jade Berthiaume
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Charlie Fortin
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Maria Teodora Rusu
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Paula W Rushton
- School of Occupational Therapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
- CHU Sainte-Justine Research Center, Montréal, Quebec, Canada
| | - Tatiana Dib
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
- CHU Sainte-Justine Research Center, Montréal, Quebec, Canada
| | - François Routhier
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Krista L Best
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
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Kenyon LK, Straw L, Wassermann M, Yasick EL, Kiger AL. School-Based Therapists' Perspectives of Wheelchair Use in US Schools: A Survey Study. Pediatr Phys Ther 2024; 36:71-78. [PMID: 38033270 DOI: 10.1097/pep.0000000000001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
PURPOSE To gather information concerning the current state of students' wheelchair (WC) use in US schools from the perspective of school-based therapists. METHODS This descriptive study used a Web-based survey to gather information regarding factors that facilitated or hindered student WC use at school, the frequency at which various tasks related to WC provision were performed, and factors that would facilitate students' independence with WC use. RESULTS A dependent manual WC was the most common type of WC mobility used at school. Various student and nonstudent factors were reported as a facilitator or a barrier to students' WC use at school. CONCLUSIONS Although most respondents reported working with a student who used a WC, few reported active engagement in tasks related to WC service provision. Future research exploring potential attitudinal issues influencing students' WC use at school and ways to optimally support students' independent WC use is indicated.
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Affiliation(s)
- Lisa K Kenyon
- The Department of Physical Therapy and Athletic Training, Grand Valley State University (Drs Kenyon, Straw, Wassermann, and Yasick), Grand Rapids, Michigan; Permobil, Inc (Ms Kiger), Lebanon, Tennessee
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Naaris M, Bekteshi S, Aufheimer M, Gerling K, Hallez H, Ortibus E, Konings M, Monbaliu E. Effectiveness of wheeled mobility skill interventions in children and young people with cerebral palsy: A systematic review. Dev Med Child Neurol 2023; 65:1436-1450. [PMID: 37021407 DOI: 10.1111/dmcn.15597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 04/07/2023]
Abstract
AIM To systematically review the effectiveness of wheeled mobility interventions in children and young people with cerebral palsy (CP). METHOD A systematic literature search was performed in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, EBSCO, PEDro, and Web of Science using database-specific concepts such as 'child' and 'wheelchair'. Studies focusing on wheeled mobility skill interventions with participants aged 6 to 21 years with CP were included. RESULTS Twenty studies with 203 participants were included. The impact of wheeled mobility skill interventions was assessed on mobility skills (n = 18), activity and participation (n = 10), and quality of life (n = 3). No studies reported effects on stress, fatigue, and motivational aspects. Interventions included power wheelchair skill training (n = 12), computer-based training (n = 5), smart wheelchair training (n = 2), and manual wheelchair training (n = 1), showing positive wheeled mobility intervention effects. Study quality based on the Methodological Index for Non-Randomized Studies scale was 9 out of 16 and 14 out of 24 for non-comparative and comparative studies respectively. Risk of bias was serious-to-critical on the Risk of Bias in Non-Randomized Studies of Interventions. INTERPRETATION Wheeled mobility interventions showed promising beneficial effects on wheeled mobility, activity and participation, and quality of life for children and young people with CP. Future studies with structured and standardized training programmes and assessment tools are warranted to further accelerate the wheeled mobility skill acquisition process in this population. WHAT THIS PAPER ADDS Wheeled mobility interventions improve wheeled mobility skills in individuals with cerebral palsy. The mobility skill acquisition process benefits from structured and standardized training. Knowledge of the intervention effects on participation and quality of life is limited. Most studies had moderate quality of evidence because of methodological limitations.
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Affiliation(s)
- Mari Naaris
- Department of Rehabilitation Sciences, Neurorehabilitation Technology Lab, Katholieke Universiteit Leuven, Bruges, Belgium
| | - Saranda Bekteshi
- Department of Rehabilitation Sciences, Neurorehabilitation Technology Lab, Katholieke Universiteit Leuven, Bruges, Belgium
| | - Maria Aufheimer
- Department of Computer Science, e-Media Research Lab, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Kathrin Gerling
- Department of Computer Science, e-Media Research Lab, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hans Hallez
- Department of Computer Sciences, Mechatronics Research Group, Katholieke Universiteit Leuven, Bruges, Belgium
| | - Els Ortibus
- Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Marco Konings
- Department of Rehabilitation Sciences, Neurorehabilitation Technology Lab, Katholieke Universiteit Leuven, Bruges, Belgium
| | - Elegast Monbaliu
- Department of Rehabilitation Sciences, Neurorehabilitation Technology Lab, Katholieke Universiteit Leuven, Bruges, Belgium
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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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Best KL, Rushton PW, Sheriko J, Arbour-Nicitopoulos KP, Dib T, Kirby RL, Lamontagne ME, Moore SA, Ouellet B, Routhier F. Effectiveness of wheelchair skills training for improving manual wheelchair mobility in children and adolescents: protocol for a multicenter randomized waitlist-controlled trial. BMC Pediatr 2023; 23:485. [PMID: 37752480 PMCID: PMC10521483 DOI: 10.1186/s12887-023-04303-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/09/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Self-directed mobility during childhood can influence development, social participation, and independent living later in life. For children who experience challenges with walking, manual wheelchairs (MWCs) provide a means for self-directed mobility. An effective MWC skills training program exists for adults, but controlled trials have not yet been documented in children and adolescents. This paper outlines the protocol for a multi-centre randomized wait-list controlled trial. The primary objective is to test the hypothesis that children and adolescents who receive MWC skills training will have higher MWC skills capacity compared to children and adolescents in the control group who receive usual care. The secondary objectives are to explore the influence of MWC skills training in children and adolescents (MWC use self-efficacy and satisfaction with participation in meaningful activities), and parents (perceived MWC skills); and to measure retention three months later. METHODS A multi-centre, parallel-group, single-blind randomized wait-list controlled trial will be conducted. A sample of 60 children and adolescents who use MWCs will be recruited in rehabilitation centres, specialized schools, and the communities of three Canadian cities. Participants will be randomized (1:1) to the experimental (Wheelchair Skills Training Program [WSTP]) or wait-list control group (usual care). Performance-based and self-report measures will be completed at baseline (T1), three months (post-intervention, T2), and three months post-intervention (T3). The primary outcome will be MWC skills capacity post-intervention. Secondary outcomes will be MWC use self-efficacy and satisfaction with participation of the child/adolescent, and parent-perceived MWC skills. The WSTP will consist of 12 sessions, 45-60 min each, delivered 1-2 times per week by trained personnel with health professions education. Training will be customized according to the child's baseline skills and participation goals that require the use of the MWC. The wait-list control group will receive usual care for 3 months and then receive the WSTP after completing T2 evaluations. Data will be analysed using ANCOVA (controlling for baseline scores). DISCUSSION MWC skills training may be one way to improve self-directed mobility and related outcomes for children and adolescents. The results of this multi-centre randomized wait-list controlled trial will allow for the effectiveness of the intervention to be evaluated in a variety of clinical contexts and geographical regions. TRIAL REGISTRATION ClinicalTrials.gov: NCT05564247, Version October 3, 2022.
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Affiliation(s)
- K L Best
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada.
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada.
| | - P W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Marie Enfant Rehabilitation, Montréal, QC, H1T 1C9, Canada
| | - J Sheriko
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - K P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, M5S 2W6, Canada
| | - T Dib
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Marie Enfant Rehabilitation, Montréal, QC, H1T 1C9, Canada
| | - R L Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, B3H 4K4, Canada
| | - M E Lamontagne
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
| | - S A Moore
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - B Ouellet
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
| | - F Routhier
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, 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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Ouellet B, Rushton PW, Côté AA, Fortin-Haines L, Lafleur E, Paré I, Barwick M, Kirby RL, Robert MT, Routhier F, Dib T, Burrola-Mendez Y, Best KL. Evaluation of pediatric-specific resources to support utilization of the Wheelchair Skills Training Program by the users of the resources: a descriptive qualitative study. BMC Pediatr 2022; 22:500. [PMID: 36002816 PMCID: PMC9402274 DOI: 10.1186/s12887-022-03539-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's ability to engage in meaningful activities is positively influenced by their ability to move independently. Preliminary evidence in children suggests that wheelchair skills training improves wheelchair skills, which are important for independent mobility. The Wheelchair Skills Training Program is a standardized program to teach wheelchair skills. However, it is underutilized in pediatric rehabilitation settings. To increase its utilization, 3 pediatric-specific Wheelchair Skills Training Program resources related to indoor skills were developed (i.e., a storybook, four instructional posters, and a training workbook). This study aimed to describe occupational therapists' (OTs) and pediatric manual wheelchair users' (PMWUs) perceived satisfaction with the storybook, instructional posters and training workbook, and to explore their perceptions regarding the usability, relevance, and feasibility of these resources in pediatric rehabilitation settings. METHODS A descriptive qualitative design was used. Convenience samples of OTs and PMWUs were recruited in a rehabilitation center and affiliated schools. A focus group with OTs and semi-structured interviews with PMWUs were conducted by videoconference to obtain participants' feedback on the resource prototypes and suggestions for improvement. Data were deductively analyzed using the Framework method. RESULTS Eight OTs and 5 PMWUs expressed general satisfaction with the resources, describing them as usable, relevant, and feasible to integrate into wheelchair skills training with novice wheelchair users and younger children. All OTs and 3 PMWUs expressed the desire to use the resources for wheelchair skills training. Two PMWUs perceived the resources were not relevant to them because they already mastered the skills. The participants suggested minor modifications for improving the resources (e.g., more action in the story, increased precision of illustrations related to the characters' position in the wheelchair). CONCLUSION OTs and PMWUs were satisfied with the resources, perceiving them to be applicable for training wheelchair skills among young children and novice wheelchair users. The resources represent a concrete solution to facilitate the use of the Wheelchair Skills Training Program in pediatric rehabilitation settings. Additional resources are needed to better reach older and more experienced PMWUs (i.e., of intermediate and advanced skill levels).
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada. .,CHU Sainte-Justine Research Center, 5200, rue Bélanger Est, Montréal, QC, H1T 1C9, Canada.
| | - Andrée-Anne Côté
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | | | - Emma Lafleur
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | - Isabelle Paré
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | - Melanie Barwick
- University of Toronto, Toronto, ON, Canada.,SickKids Research Institute, Toronto, ON, Canada
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada
| | - Maxime T Robert
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Tatiana Dib
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada.,CHU Sainte-Justine Research Center, 5200, rue Bélanger Est, Montréal, QC, H1T 1C9, Canada
| | - Yohali Burrola-Mendez
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada.,CHU Sainte-Justine Research Center, 5200, rue Bélanger Est, Montréal, QC, H1T 1C9, Canada
| | - Krista L Best
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
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Feldner HA, LaForme Fiss A, Jeffries LM, McCoy SW. Understanding Acceptability, Barriers, and Facilitators to Clinical Implementation of the on Track Developmental Monitoring System for Children with Cerebral Palsy: A Qualitative Study. Phys Occup Ther Pediatr 2022; 42:384-402. [PMID: 35361046 PMCID: PMC9333186 DOI: 10.1080/01942638.2022.2058335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS On Track Developmental Monitoring System (DMS) is a novel series of tools to assist in shared-decision making, guide rehabilitation intervention based on functional ability levels, and promote episodic care service models. Further understanding of the acceptability, feasibility, and appropriateness of On Track DMS in clinical settings is critical. The purpose of this study was to understand clinician perspectives of the acceptability of On Track DMS and to identify potential implementation barriers and facilitators within pediatric physical therapist practice. METHODS Three, day-long training workshops were conducted with 32 pediatric physical therapists across the US. Focus groups with 21 workshop participants were conducted following training. Results were audio recorded, transcribed verbatim, and coded into themes. RESULTS Three themes emerged from the data: (1) Valuing the On Track Approach to Intervention; (2) Setting-Specific Needs and Challenges to Implementation; and (3) Training Material/Tool Strengths and Limitations. CONCLUSIONS On Track DMS appears to have initial value and acceptability for pediatric physical therapists across practice settings. Perceived benefits include facilitation of data-driven practice and therapist/family collaboration to improve health outcomes for children with CP. Using this data to understand and assess barriers and facilitators to knowledge use are first steps in successfully implementing On Track DMS.
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Affiliation(s)
- Heather A Feldner
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | | | - Lynn M Jeffries
- Department of Rehabilitation Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sarah Westcott McCoy
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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