1
|
Naaris M, Konings M, Ortibus E, Monbaliu E. Wheelchair skills training improves power mobility and participation in young people with cerebral palsy. Dev Med Child Neurol 2024. [PMID: 38968335 DOI: 10.1111/dmcn.16019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/07/2024]
Abstract
AIM To explore the effect of a 4-week structured power wheelchair skills training programme (WSTP) intervention on mobility skills and participation in children and young people (CYP) with cerebral palsy (CP). METHOD This was a one-group, repeated-measures study; baseline, intervention, and retention phases, each lasting 4 weeks, were used. Twelve participants (three females, nine males) with a mean age of 15 years 11 months (SD = 3 years 6 months) classified in Gross Motor Function Classification System levels IV and V participated in the study. To be included in the study, individuals had to be aged 6 to 21 years and currently using a power wheelchair. Participants received 12 WSTP training sessions of 45 minutes, 3 times per week. Power mobility skills were assessed using the Wheelchair Skills Test (WST) before baseline, before the intervention, after the intervention, and at the follow-up; mobility-related participation was assessed with the Canadian Occupational Performance Measure (COPM). Generalized mixed models with Bonferroni correction were used to assess the differences between the assessment points (p < 0.05). RESULTS Statistical analysis showed a 10.4% (12.5) increase in WST total scores (p < 0.001) after the intervention compared to before the intervention, and a 1-point (0.9) increase in the COPM performance subdomain (p = 0.002). INTERPRETATION Power mobility skills and mobility-related participation improved after a 4-week WSTP intervention in CYP with CP. Thus, task-based power mobility skills training based on the WSTP, and in line with individualized needs and capabilities, taking place in a natural environment, should be recommended. Power mobility skills training needs to be structured and individualized; the training interventions must consider the individual, the task, and the environment.
Collapse
Affiliation(s)
- Mari Naaris
- Department of Rehabilitation Sciences Neurorehabilitation Technology Lab, KU Leuven, Bruges, Belgium
| | - Marco Konings
- Department of Rehabilitation Sciences Neurorehabilitation Technology Lab, KU Leuven, Bruges, Belgium
| | - Els Ortibus
- Department of Development and Regeneration PRONTO Research Lab, KU Leuven, Leuven, Belgium
| | - Elegast Monbaliu
- Department of Rehabilitation Sciences Neurorehabilitation Technology Lab, KU Leuven, Bruges, Belgium
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Curi HT, Ferretti EC, de Soárez PC. Wheelchair outcome measurement instruments for children: a scoping review protocol. Disabil Rehabil Assist Technol 2024:1-6. [PMID: 38372226 DOI: 10.1080/17483107.2024.2319278] [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: 10/27/2023] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
Purpose: The proposed scoping review aims to explore and map wheelchair outcome measurement instruments for children in the literature.Method: The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. The review question and eligibility criteria were developed using the PCC (population, concept, context) mnemonic as follows: (P) children manual or motorised wheelchair users (aged ≤ 18 years), (C) wheelchair outcome measurement instruments, (C) primary sources of literature. The search will be conducted in nine relevant electronic databases. including grey literature from Academic Google. Study screening, selection, and data extraction will be performed independently by two authors. A third reviewer will resolve discrepancies between the authors. General characteristics, population, feasibility, interpretability data will be extracted in accordance with the COSMIN methodology (Consensus-based Standards for the selection of health Measurement Instruments). This will encompass data pertaining to the measurement properties of the domains of reliability, validity and responsiveness. A descriptive analysis will be carried out, and the results will be classified into categories and presented in tables accompanied by a descriptive summary.Results: The results can inform future research directions, clinical practice and the development of wheelchair outcome measurement instruments. Furthermore, it will help professionals in rehabilitation and wheelchair services to find the wheelchair outcome measurement instruments according to the target population and cultural context.
Collapse
Affiliation(s)
- Haidar Tafner Curi
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Sao Paulo, Brazil
| | - Eliana Chaves Ferretti
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, Sao Paulo, Brazil
| | - Patrícia Coelho de Soárez
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Sao Paulo, Brazil
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|