Development of a wheelchair maintenance training programme and questionnaire for clinicians and wheelchair users

Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users.

METHODS

The WMTP and WMT-Q were developed through an iterative process.

RESULTS

A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p < 0.007).

CONCLUSION

The WMTP will continue to be revised as it is further implemented. The WMT-Q is an acceptable instrument to measure pre- and post-training maintenance knowledge. Implications for Rehabilitation The Wheelchair Maintenance Training Program can be used to educate rehabilitation clinicians and technicians to improve wheelchair service and delivery to end users. This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers. This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown. This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.

The impact of transfer setup on the performance of independent wheelchair transfers

OBJECTIVE

The aim of this study was to determine how selected environmental factors affect transfers and to compare our results to the Americans with Disabilities Act Accessibility Guidelines (ADAAG).

BACKGROUND

Few data are available to support standards development related to transfers in the built environment.

METHOD

Participants were 120 wheeled mobility device (WMD) users who transferred to and from a modular transfer station that consisted of a height-adjustable platform with a lateral grab bar, optional obstacle to the transfer, and an optional height-adjustable front grab bar. Maximum and minimum vertical heights of the transfer surface, maximum gap distance between the WMD and transfer surface, grab bar use, and WMD space needs were recorded.

RESULTS

The 95th percentile lowest and highest heights attained were similar to the median WMD seat-to-floor height (56 cm).We found that 42% (47/113) could not perform a transfer with the obstacle present. Participants transferred higher when the front grab bar was added to the setup (p = .005) and higher and lower with the front grab bar than without it when the obstacle was present in the setup (p = .003 and p = .005, respectively). We found that 95% of participants performed a transfer across an 8.9-cm gap. ADAAG recommendations fall short for the height and clear-space needs of the 50th-percentile WMD users.

CONCLUSION

Revisions concerning transfer heights, gaps, clear spaces, and grab bar heights are necessary to make transfers more accessible to WMD users.

APPLICATION

The data will be used to revise the guidelines related to transfers and to enable designers and engineers to create an environment that is more accessible.