Virtual Peer Coaching for Paraplegia

Overseen By Lee Tempest, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

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

Compensation: Varies

Number of Visits: 8

132 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Virtual Peer Coaching, Remote Manual Wheelchair Skills Training Program, Peer-Led Wheelchair Skills Training?

Research shows that peer-led wheelchair training programs, like the WheelSeeU program, are effective in improving wheelchair skills and confidence among users. Additionally, remote learning and mHealth (mobile health) interventions have been found feasible and beneficial for enhancing wheelchair skills, especially for older adults who may have limited access to traditional rehabilitation services. ^{1 2 3 4 5}

Is Virtual Peer Coaching for Paraplegia safe for humans?

The research does not provide specific safety data for Virtual Peer Coaching or similar programs, but peer-led wheelchair training programs have been studied for feasibility and satisfaction, suggesting they are generally well-tolerated. ^{1 6 7 8 9}

How is the Virtual Peer Coaching treatment for paraplegia different from other treatments?

Virtual Peer Coaching is unique because it uses remote, peer-led training to help individuals with paraplegia improve their wheelchair skills, offering a flexible and accessible alternative to traditional in-person rehabilitation programs. ^{10 11 12 13 14}

What is the purpose of this trial?

The objective of this study is to determine the effectiveness of remote manual wheelchair skills training program. First, peer coaches will be enrolled and trained. Then, trainees will be enrolled into one of three interventions: intervention with remote feedback (Group 1), wait list control group (Group 2), and structured self-study (Group 3).

Research Team

Lynn Worobey, PhD/DPT

Principal Investigator

University of Pittsburgh

Eligibility Criteria

This trial is for adults over 18 with non-progressive spinal cord injury (SCI) who use a manual wheelchair for at least half of their mobility. Participants must speak and read English, live in the community, have internet access with video capability, and be able to practice wheelchair skills with a spotter.

Inclusion Criteria

Trainees: Non-progressive SCI

Coaches: Non-progressive SCI

Trainees: Access to an Internet-ready device with video capabilities

Exclusion Criteria

Not applicable.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training for Peer Coaches

Peer coaches undergo virtual training on peer mentoring, research ethics, and wheelchair skills training

3 weeks

Virtual training sessions

Intervention A

Trainees engage in 1:1 virtual zoom meetings facilitated by the study team scheduled weekly for 6 sessions with the opportunity for 2 makeup sessions

6-8 weeks

6-8 virtual sessions

Intervention B

Participants review educational videos and practice skills with access to materials for 8 weeks

8 weeks

Follow-up

Participants are monitored for safety and effectiveness after training with follow-up assessments at 2, 6, 8, and 12 months

12 months

Follow-up assessments at 2, 6, 8, and 12 months

Treatment Details

Interventions

• Virtual Peer Coaching

Trial Overview The study tests the effectiveness of remote manual wheelchair training. It compares three groups: one receiving remote feedback from peer coaches, another on a waitlist (control group), and the last doing structured self-study without direct coaching.

Participant Groups

Group I: Active intervention (intervention A) Experimental Treatment 1 Intervention

Active intervention (intervention A) which will include training through peer coaching

Group II: Waitlist control group Active Control 1 Intervention

Waitlist control group that will receive the same intervention A but at 6 months

Group III: Self-study intervention Active Control 1 Intervention

Self-study intervention with review of educational materials

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

Findings from Research

The WheelSeeU program, a peer-led manual wheelchair training initiative, demonstrated high feasibility with a 90% participant retention rate and no reported adverse events among the 40 older adult participants (mean age 65 years).

All participants reported perceived benefits from the program, indicating that it effectively meets the training needs of older adults without increasing the burden on clinicians.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of the trial procedures for a randomized controlled trial of a community-based peer-led wheelchair training program for older adults. Best, KL., Miller, WC., Routhier, F., et al.[2023]

The WheelSeeU program significantly improved older adults' autonomy and mobility skills with manual wheelchairs, leading to a positive impact on their daily lives.

Participants reported enhanced self-efficacy and social inclusion, highlighting the program's effectiveness in fostering community connections and personal empowerment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring Older Adults' Experiences and Perceptions with a Peer-Led Wheelchair Training Program. Pellichero, A., Best, KL., Routhier, F., et al.[2021]

The mHealth wheelchair skills training program for manual wheelchair users aged 55 and older was found to be feasible, with a high retention rate of 94% and 78% of participants completing the minimum training requirement over four weeks.

Participants reported significant satisfaction with the program, indicating a 98% agreement on perceived benefits, suggesting that this approach could enhance community participation and quality of life for older adults with mobility challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized control trial feasibility evaluation of an mHealth intervention for wheelchair skill training among middle-aged and older adults. Giesbrecht, EM., Miller, WC.[2020]

A pilot study involving six new manual wheelchair users with spinal cord injuries showed that a repetition-based training program significantly improved their wheelchair propulsion biomechanics after nine 90-minute sessions.

While the training led to better propulsion patterns, it did not result in significant changes in peak and average push forces or overall wheelchair skills, indicating that while biomechanics can improve, skill acquisition may require different training approaches.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A motor learning approach to training wheelchair propulsion biomechanics for new manual wheelchair users: A pilot study. Morgan, KA., Tucker, SM., Klaesner, JW., et al.[2022]

A six-week Remote-Learning Course significantly improved wheelchair service providers' subjective performance scores by 29.6% and confidence scores by 29.9%, based on assessments from 121 participants with an average of 6 years of experience.

Participants reported the Course as useful and relevant, with most recommending it to others, indicating a positive reception and perceived value in enhancing their skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Remote-Learning Course can improve the subjective wheelchair-skills performance and confidence of wheelchair service providers: an observational cohort study. Kirby, RL., Smith, C., Osmond, D., et al.[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]

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]

The online version of the wheelchair maintenance training program (WMTP) significantly improved participants' knowledge and confidence, with scores increasing dramatically after the training, indicating its effectiveness.

Participants in both the online and in-person WMTP showed similar improvements in knowledge, suggesting that web-based training is a viable alternative to traditional in-person methods for wheelchair maintenance education.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and efficacy of an online wheelchair maintenance training program for wheelchair personnel. Múnera, S., Pearlman, J., Toro, M., et al.[2021]

A pilot study involving eight children and adolescents with cerebral palsy and spina bifida showed that a peer-led wheelchair training program significantly improved their satisfaction with participation, wheelchair skills, and self-efficacy in using their wheelchairs.

The results suggest that community-based, peer-led training can be effective for enhancing wheelchair outcomes in young users, although further research with larger groups is needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Ouellet, B., Best, KL., Wilson, D., et al.[2023]

A virtual training program for peer coaches with rheumatoid arthritis was successfully implemented during the COVID-19 pandemic, demonstrating feasibility and acceptability among participants.

The training, which focused on listening, discussing, practicing, and certifying, resulted in high satisfaction and confidence among the coaches, highlighting the potential for virtual formats to enhance recruitment and diversity in peer coaching interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual training of rheumatoid arthritis peer coaches in motivational interviewing skills and concepts of cardiovascular disease. Brown, M., Páez, YD., Jabri, A., et al.[2023]

Peer coaching provides valuable support for individuals with diabetes, helping them make better dietary and activity choices.

For peer support to be effective, it is essential to have a structured follow-up program in place to ensure ongoing assistance and accountability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The benefits of peer support with diabetes. McPherson, SL., Joseph, D., Sullivan, E.[2022]

The study evaluated the effectiveness of Diabetes Education by Peer Coaching on diabetes management, measuring outcomes like Fasting Blood Sugar (FBS) and HbA1c over 12 months with various secondary health indicators.

Results suggest that peer coaching can enhance self-control and self-efficacy in diabetes management, indicating it may be a beneficial interactive approach to diabetes education tailored to specific cultural contexts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effectiveness of a Peer Coaching Education on Control and Management of Type 2 Diabetes in Women: A Protocol for a Randomized Controlled Trial. Aalaa, M., Sanjari, M., Aghaei Meybodi, HR., et al.[2020]

The use of a collaborative virtual patient platform for peer-assisted learning significantly improved medical interview scores among 206 preclerkship students, with a notable increase in scores (P=.04) and a trend towards higher passing rates (P=.11) at the Objective Structured Clinical Examination (OSCE).

Students reported reduced stress and appreciated the platform's intuitive design, diversity of cases, and automated feedback, indicating that peer-assisted learning can effectively enhance medical education beyond traditional methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of a Student-Driven, Virtual Patient Application on Objective Structured Clinical Examination Performance: Observational Study. Bergeron, D., Champagne, JN., Qi, W., et al.[2019]

This study is a feasibility trial assessing the effectiveness of volunteer peer health coaching for patients with long-term health conditions and low activation levels, aiming to improve their health management skills and confidence.

The trial will evaluate recruitment, retention, and adherence rates, as well as measure patient activation and mental health outcomes, to inform a larger definitive trial in the future.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Protocol for a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions: PEER CONNECT. Dennett, R., Thompson, T., Clyne, W., et al.[2022]

References

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

Feasibility of the trial procedures for a randomized controlled trial of a community-based peer-led wheelchair training program for older adults. [2023]

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

Exploring Older Adults' Experiences and Perceptions with a Peer-Led Wheelchair Training Program. [2021]

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

A randomized control trial feasibility evaluation of an mHealth intervention for wheelchair skill training among middle-aged and older adults. [2020]

4. England pubmed.ncbi.nlm.nih.gov

A motor learning approach to training wheelchair propulsion biomechanics for new manual wheelchair users: A pilot study. [2022]

5. England pubmed.ncbi.nlm.nih.gov

A Remote-Learning Course can improve the subjective wheelchair-skills performance and confidence of wheelchair service providers: an observational cohort study. [2023]

6. England pubmed.ncbi.nlm.nih.gov

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

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

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

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

Development and efficacy of an online wheelchair maintenance training program for wheelchair personnel. [2021]

9. Switzerland pubmed.ncbi.nlm.nih.gov

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. [2023]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Virtual training of rheumatoid arthritis peer coaches in motivational interviewing skills and concepts of cardiovascular disease. [2023]

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

The benefits of peer support with diabetes. [2022]

12. Iran pubmed.ncbi.nlm.nih.gov

The Effectiveness of a Peer Coaching Education on Control and Management of Type 2 Diabetes in Women: A Protocol for a Randomized Controlled Trial. [2020]

13. Canada pubmed.ncbi.nlm.nih.gov

Impact of a Student-Driven, Virtual Patient Application on Objective Structured Clinical Examination Performance: Observational Study. [2019]

14. England pubmed.ncbi.nlm.nih.gov

Protocol for a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions: PEER CONNECT. [2022]