Influence of peer-led wheelchair training on wheelchair skills and participation in older adults: Clinical outcomes of a randomized controlled feasibility trial.

Influence of peer-led wheelchair training on wheelchair skills and participation in older adults: Clinical outcomes of a randomized controlled feasibility trial.

Arch Phys Med Rehabil. 2018 Nov 23;:

Authors: Miller WC, Best KL, Eng JJ, Routhier F

Abstract
OBJECTIVES: To estimate treatment effect size of a peer-led 'Wheelchair training self-efficacy enhanced for use' (WheelSeeU) program on objective wheelchair skills (primary); and on perceived wheelchair skills capacity and performance, wheelchair use-self-efficacy, satisfaction with participation, life-space mobility, and participation frequency (secondary); and to evaluate retention six months later (secondary).
DESIGN: Randomized controlled trial.
SETTING: Rehabilitation centres, communities.
PARTICIPANTS: Community-living older adults.
INTERVENTION: WheelSeeU comprised six, 90 minutes peer-led sessions of customized training (in pairs) according to participants' goals. A support-trainer provided spotting. The control group comprised six, 90-minute professional-led didactic information sessions (in pairs).
MAIN OUTCOME MEASURES: The Wheelchair Skills Test (WST), Wheelchair Skills Test Questionnaire (WST-Q), Wheelchair Use Confidence Scale for Manual Wheelchair Users (WheelCon), Wheelchair Outcomes Measure (WhOM), Life Space Mobility (LSA), and Late Life Function and Disability Index (LLFDI) were collected at baseline (T1), post-intervention (T2), and six-months post-intervention (T3).
RESULTS: Of 121 screened, 39 individuals did not meet the inclusion criteria and 41 declined to participate. Forty participants (64.5 years of age; 60% male) were randomized, 38 completed the intervention, and 35 completed T3 assessments. There were no adverse effects. WheelSeeU did not have a statistically significant greater effect on objective WST (primary) or WST-Q capacity, WheelCon, LSA, and LLFDI at T2 compared to the control group. Effect sizes were statistically significant and large for WST-Q performance (Cohen's d = 0.72) and the WhOM (Cohen's d = 0.82) at T2, and effects were retained at T3.
CONCLUSIONS: Compared to an active control group, WheelSeeU did not have a greater effect on wheelchair skills capacity. However, WheelSeeU should not be prematurely dismissed as an approach to potentially improve wheelchair skills performance and satisfaction with participation in meaningful activities. Gender and depression are important when designing interventions for older adults.

PMID: 30476489 [PubMed - as supplied by publisher]

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