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

4 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial tests a training program called Skills on Wheels, which helps children with physical disabilities learn to use manual wheelchairs on their own. The goal is to make them more confident and safe in using their wheelchairs, and to improve their social skills and participation in activities.

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 data supports the effectiveness of the treatment Manual Wheelchair Skills Training for mobility impairments?

Research shows that wheelchair skills training programs can significantly improve wheelchair skills performance, confidence, and frequency of use for people with mobility impairments, such as those with lower limb amputation or spinal cord injury. These programs are also found to be safe and more effective than standard rehabilitation alone. ^{1 2 3 4 5}

Is wheelchair skills training safe for humans?

Research shows that wheelchair skills training is generally safe for humans, as several studies have tested its safety and found it to be a safe practice for improving wheelchair skills. ^{1 5 6 7 8}

How does Manual Wheelchair Skills Training differ from other treatments for mobility impairments?

Manual Wheelchair Skills Training is unique because it focuses on teaching practical skills for using a manual wheelchair, which can improve confidence and frequency of use. Unlike traditional in-person training, it can be delivered through innovative methods like eHealth applications and peer-led sessions, making it more accessible and adaptable to individual needs. ^{3 7 8 9 10}

Eligibility Criteria

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

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)

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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]

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]

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 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]

References

1. England pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Goal satisfaction improves with individualized powered wheelchair skills training. [2018]

3. Australia pubmed.ncbi.nlm.nih.gov

Facilitating manual wheelchair skills following lower limb amputation using a group process: A nested mixed methods pilot study. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of Group Wheelchair Skills Training for People With Spinal Cord Injury: A Randomized Controlled Trial. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Wheelchair skills training program: A randomized clinical trial of wheelchair users undergoing initial rehabilitation. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Wheelchair skills training for community-based manual wheelchair users: a randomized controlled trial. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Understanding the task demands for powered wheelchair driving: a think-aloud task analysis. [2022]

8. England pubmed.ncbi.nlm.nih.gov

A cross-sectional survey investigating wheelchair skills training in Ireland. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

Feasibility RCT protocol evaluating a powered-wheelchair training program for older adults. [2019]