Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial

Effects of wheelchair skills training during peer-led Active Rehabilitation Camps for people with spinal cord injury in Poland: a cohort study

STUDY DESIGN

Prospective cohort study.

OBJECTIVES

To evaluate the effects of wheelchair skills training (WSTR) for participants with spinal cord injury (SCI) during peer-led Active Rehabilitation Camps (ARC) in Poland. We hypothesized that participation in ARC will improve wheelchair skill performance and self-efficacy in individuals with SCI. We also aimed to determine demographic and injury-related factors associated with greater improvements in wheelchair skill performance and self-efficacy.

SETTING

Thirteen consecutive ARCs in Poland.

METHODS

Participants (n = 122) with traumatic or nontraumatic SCI older than 16 years were evaluated at the beginning (T1) and completion (T2) of ARC and at 3-month follow-up (T3) through the Queensland Evaluation of Wheelchair Skills (QEWS) and the Wheelchair Skills Test Questionnaire (WST-Q).

RESULTS

At T2, 43% of participants reached the threshold for substantial clinically meaningful change in QEWS, 73% in WST-Q capacity, and 67% in confidence, with approximately half of those reporting such gains at T3. At a group level, participants achieved small effect-size improvements (QEWS) at T2; large effects in wheelchair skills capacity at T2 and T3; large effects in wheelchair skill confidence at T2, and low effects at T3. Prior attendance to ARC was the only independent variable that explained 10% of variance in wheelchair capacity gains.

CONCLUSIONS

Peer-led WSTR during ARCs is highly effective at improving wheelchair skills in individuals with SCI. These improvements are largely retained after three months. Persons with SCI should have a chance to participate in more than one camp to maintain and further improve their wheelchair skills.

Community mobility and participation assessment of manual wheelchair users: a review of current techniques and challenges

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.

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

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.