Wheelchair Skills Training for Mobility Impairments

Overseen By Lisa Kenyon, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Grand Valley State University

Disqualifiers: Unsafe wheelchair, Safety concerns, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether specialized training can help children who use manual wheelchairs become more skilled and confident in their wheelchair use. The goal is to determine if such training can improve their social participation and overall adaptability. It targets children who have difficulty walking, use a manual wheelchair at least a quarter of the time, and live in Michigan. Participants should be able to follow simple instructions and have a parent or caregiver who speaks English. The trial aims to gather data for a future, larger study that could improve the quality of life for children with mobility impairments. As an unphased trial, this study offers a unique opportunity for participants to contribute to pioneering research that could enhance the lives of children with mobility challenges.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on wheelchair skills training, so it's unlikely to require changes to your medication.

What prior data suggests that this wheelchair skills training is safe for children?

Research shows that training in using manual wheelchairs is generally safe and well-received. Studies have found that this training helps adults improve their wheelchair skills and gain confidence. Although less research exists on training for children, available evidence suggests it can be done safely. No studies on adults have reported negative effects from the training itself. This implies that children might also handle the training well, though more research is needed to confirm this. Overall, the focus remains on improving skills and safety, which could help prevent injuries from incorrect wheelchair use. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about manual wheelchair skills training for mobility impairments because it focuses on enhancing the practical skills needed to navigate daily life effectively. Unlike traditional physical therapy that often emphasizes general strength and conditioning, this training is specifically tailored to improve the proficiency with which individuals use their manual wheelchairs. By targeting real-world challenges, such as maneuvering tight spaces and efficiently propelling the wheelchair, this approach aims to empower users with greater independence and confidence in their mobility.

What evidence suggests that manual wheelchair skills training is effective for improving mobility in children with physical disabilities?

Research has shown that training in manual wheelchair use can greatly improve skills and boost confidence for adults. Although few studies focus on children, early results suggest that this training might also help young users move independently, feel more confident, and participate in social activities. Participants in this trial will receive manual wheelchair skills training, enhancing their belief in their ability to succeed and improving their wheelchair handling in various situations. By mastering these skills, the training could reduce injury risk and promote independence, which is crucial for a better quality of life. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for children aged 5-17 with physical disabilities like spinal cord injury, cerebral palsy, or genetic disorders who use a manual wheelchair at least 25% of the time. They must be able to follow simple instructions and have an English-speaking parent/caregiver. Participants need to live in Michigan and have a safe wheelchair.

Inclusion Criteria

Resides in Michigan

I have trouble walking due to my condition.

I use a manual wheelchair for at least a quarter of my day.

Exclusion Criteria

My child's wheelchair is deemed unsafe by a professional.

Any reason that it would not be safe for the child to participate in manual wheelchair training (as assessed by the PI, a licensed physical therapist)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo a 6-week manual wheelchair skills training program

6 weeks

Weekly sessions

Follow-up

Participants are monitored for changes in behavior, perceptions, and adaptive skills

4 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Manual Wheelchair Skills Training

Trial Overview The 'Skills on Wheels' program aims to improve manual wheelchair skills and confidence among children with physical disabilities. It will also assess the impact on psychosocial skills, social participation, and adaptive behavior as part of pilot data for future research.

How Is the Trial Designed?

Group I: Manual wheelchair skills training Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

Grand Valley State University

Lead Sponsor

Trials

13

Recruited

8,700+

Published Research Related to This Trial

A survey of Irish health professionals revealed that while wheelchair skills training is commonly provided to new users, it primarily focuses on basic skills like transfers and simple mobility, with advanced skills being taught infrequently.

There is a strong consensus among respondents for the need to develop standardized training programs and continued education in advanced wheelchair skills to enhance the confidence and knowledge of service providers, ultimately improving mobility for wheelchair users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A cross-sectional survey investigating wheelchair skills training in Ireland. Mathis, K., Gowran, RJ.[2023]

A study involving 10 participants (5 experienced powered wheelchair users and 5 expert clinicians) identified 110 distinct skills and abilities necessary for safe indoor powered wheelchair use, highlighting the complexity of this task.

The research revealed that about 50% of these skills are mental functions, and it emphasized the need for training programs to cover a wide range of skills and knowledge, including understanding oneself, the environment, the wheelchair, and the specific tasks involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding the task demands for powered wheelchair driving: a think-aloud task analysis. Smith, EM., Mortenson, WB., Mihailidis, A., et al.[2022]

The pilot study involving 11 participants with lower limb amputations demonstrated significant improvements in wheelchair skill performance, confidence, and usage frequency after completing a structured training program, with 91% of participants achieving or exceeding their goals.

Qualitative feedback highlighted key themes such as motivators for learning and the importance of training structure, indicating that the program not only enhances practical skills but also boosts participants' confidence and safety in wheelchair use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Facilitating manual wheelchair skills following lower limb amputation using a group process: A nested mixed methods pilot study. Charlton, K., Murray, C., Boucaut, R., et al.[2022]

A feasibility study is being conducted with 32 older adults with mild to moderate cognitive impairment to evaluate a powered-wheelchair training program that uses errorless learning strategies and shared control technology.

The program aims to improve powered-wheelchair skills, suggesting that this method could effectively address the learning needs of older adults who struggle with traditional training methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility RCT protocol evaluating a powered-wheelchair training program for older adults. Smith, EM., Miller, WC., Mortenson, WB., et al.[2019]

A randomized controlled trial with 35 wheelchair users showed that a formalized Wheelchair Skills Training Program (WSTP) is safe and leads to significant improvements in wheelchair skills performance, with the treatment group achieving a 25% increase in skills compared to an 8% increase in the control group.

The WSTP specifically enhanced skills such as gravel and high-curb descent, indicating that targeted training can greatly improve independent mobility for new wheelchair users, suggesting a need for its inclusion in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Wheelchair skills training program: A randomized clinical trial of wheelchair users undergoing initial rehabilitation. MacPhee, AH., Kirby, RL., Coolen, AL., et al.[2022]

The TEAM Wheels program, which combines app-based self-training and peer-led teleconference sessions, aims to improve skills training for manual wheelchair users, addressing the challenges of traditional in-person training methods.

This randomized control trial will evaluate the program's effectiveness in enhancing mobility, participation, and quality of life for individuals transitioning to wheelchair use, with outcomes measured at baseline, post-treatment, and 6 months later.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial. Giesbrecht, E., Faieta, J., Best, K., et al.[2021]

A wheelchair skills training program significantly improves manual wheelchair skills capacity in the short term, with a 13.26% increase in skills test scores compared to control groups in randomized controlled trials and a 23.44% increase in non-randomized studies.

While the training shows short-term benefits, the long-term effectiveness of manual wheelchair skills training and the effectiveness of powered wheelchair skills training remain unclear, with insufficient evidence to support lasting advantages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review. Tu, CJ., Liu, L., Wang, W., et al.[2022]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40742628/

Efficacy of Manual Wheelchair Skills Training for Improving ... Wheelchair skills training has been shown to be effective for improving manual skills and confidence among adult users with various diagnoses, ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12355141/

Efficacy of Manual Wheelchair Skills Training for Improving ... Secondary outcomes will include manual wheelchair skills capacity, self-efficacy, and mobility. Semistructured individual interviews will be ...

3. bmcpediatr.biomedcentral.com bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04303-8

Effectiveness of wheelchair skills training for improving ... MWC skills training may be one way to improve self-directed mobility and related outcomes for children and adolescents.

4. clinicaltrials.gov clinicaltrials.gov/study/NCT01243164?cond=(usher%20syndromes%20type%20ig)%20OR%20(using)&checkSpell=&rank=1

Efficacy of Wheelchair Skills Training on Confidence Using ... Purpose: The overall goal of this research project is to evaluate the efficacy of the Wheelchair Skills Training Program on confidence with using a manual ...

5. research.aota.org research.aota.org/ajot/article/75/1/7501205160p1/8392/Improvement-and-Retention-of-Wheelchair-Skills

Improvement and Retention of Wheelchair Skills Training for ... Conclusions and Relevance: Results confirm improved wheelchair self-efficacy, capacity, and self-efficacy with clinical intervention skills.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11649964/

Manual wheelchair training approaches and intended ... What wheelchair training approaches and intended training outcomes are reported for adult manual wheelchair users? Objective 1: To document ...

7. bmcmededuc.biomedcentral.com bmcmededuc.biomedcentral.com/articles/10.1186/s12909-025-06718-6

Manual wheelchair training programs: a scoping review of ... This scoping review aims to map the educational approaches documented for manual wheelchair training and to record intended learning outcomes.

8. scireproject.com scireproject.com/evidence/wheeled-mobility-and-seating-equipment/manual-wheelchairs/wheelchair-use/wheelchair-skills/

Wheelchair Skills There is limited research about other outcomes including safety, mobility and social participation. Two studies evaluated wheelchair skills training approaches.

9. researchprotocols.org researchprotocols.org/2025/1/e66974

Efficacy of Manual Wheelchair Skills Training for Improving ... Wheelchair skills training has been shown to be effective for improving manual skills and confidence among adult users with various diagnoses, ...

10. hsrd.research.va.gov hsrd.research.va.gov/research/abstracts.cfm?Project_ID=2141697627

IIR 06-274 – HSR Study - VA Health Systems Research After three time points of data collection, wheelchair skills improved significantly (p<0.001) for both groups, although those who received the training ...