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Powered Wheelchair Skills Training for Persons with Stroke: A Randomized Controlled Trial

Mountain, Anita D. MD, FRCPC; Kirby, R. Lee MD, FRCPC; Smith, Cher MSc; Eskes, Gail PhD; Thompson, Kara MSc

American Journal of Physical Medicine & Rehabilitation: December 2014 - Volume 93 - Issue 12 - p 1031–1043
doi: 10.1097/PHM.0000000000000229
Original Research Articles: CME Article . 2014 Series . Number 8

Objective The aims of this study were to test the hypothesis that people with stroke who receive formal powered wheelchair skills training improve their wheelchair skills to a significantly greater extent than participants in a control group who do not and to explore the influence of spatial neglect.

Design Seventeen participants with stroke (including nine with spatial neglect) were randomly allocated to intervention (n = 9) or control (n = 8) groups. Those in the intervention group received up to five 30-min training sessions based on the Wheelchair Skills Training Program 4.1. The powered Wheelchair Skills Test version 4.1 was administered at baseline (T1) and after training (T2).

Results A rank order analysis of covariance on the T2 Wheelchair Skills Test score, having adjusted for the T1 score, showed a significant effect caused by group (P = 0.0001). A secondary analysis showed no significant effect caused by spatial neglect (P = 0.923).

Conclusions People with stroke who receive formal powered wheelchair skills training improve their powered wheelchair skills to a significantly greater extent (30%) than participants who do not (0%). The extent of change was not affected by the presence of spatial neglect. These findings have significance for the wheelchair provision process and the rehabilitation of people with stroke.

From the Division of Physical Medicine and Rehabilitation (ADM, RLK), Department of Medicine (KT), Research Methods Unit (KT), and Department of Psychiatry (GE), Dalhousie University; and Department of Occupational Therapy, Capital District Health Authority (CS), Halifax, Nova Scotia, Canada.

All correspondence and requests for reprints should be addressed to: R. Lee Kirby, MD, FRCPC, Nova Scotia Rehabilitation Centre, Room 206, 1341 Summer St, Halifax, Nova Scotia, Canada B3H 4K4.

Supported by the Capital District Health Authority Research Fund.

Presented in part at the Annual Meeting of Rehabilitation Engineering and Assistive Technology Society of North America, June 11–15, 2014, Indianapolis, IN.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is associated.

Reprints not available from the authors.

Clinical Trials Registry Number: NCT 00924872.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins