Effectiveness of Group Wheelchair Maintenance Training for People with Spinal Cord Injury: A Randomized Controlled Trial.
Effectiveness of Group Wheelchair Maintenance Training for People with Spinal Cord Injury: A Randomized Controlled Trial.
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DOI：
10.1016/j.apmr.2021.02.031
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发表时间：
2022-04
影响因子：
4.3
通讯作者：
Boninger ML
中科院分区：
文献类型：
--
作者：
Worobey LA;McKernan G;Toro M;Pearlman J;Cowan RE;Heinemann AW;Dyson-Hudson TA;Pedersen JP;Mesoros M;Boninger ML
评估团体轮椅维护培训的有效性并调查与培训反应相关的参与者特征。随机对照试验，包括立即组和等待名单对照组 (WLCG)，他们在 6 个月的延迟后接受干预。四个脊髓损伤模型系统中心。患有脊髓损伤的手动轮椅 (MWC) 和电动轮椅 (PWC) 使用者（n=80 和 67，分别）。两次 90 分钟的结构化轮椅维护培训课程，每班 12-20 人，并为 MWC 和 PWC 用户单独上课。每节课都包括亲自动手演示和轮椅维护练习。使用轮椅维护培训问卷 (WMT-Q) 能力（完成能力）、表现（完成频率）和基线、1 个月、6 个月、6 个月预培训（仅限 WLCG）和 1 年（仅限立即）知识，对 MWC 和 PWC 用户进行了单独分析。干预后，立即和 WLCG 的参与者通过培训提高了维护能力（MWC 和 PWC，p<0.001）和表现（MWC 和 PWC，p<0.001）。只有 PWC 用户提高了轮椅维护知识 (p<0.001)。对于两个 WLCG（MWC 和 PWC），6 个月的训练前时间点和基线之间没有差异。对培训做出回应的 MWC 用户在所有领域的 WMT-Q 得分均较低，而对于 PWC 用户而言，这仅是知识方面的情况。团体轮椅技能培训可有效提高 MWC 和 PWC 用户完成维护的能力和维护活动的表现，即使是在一群经验丰富的轮椅使用者中也是如此。对于 MWC 用户来说，改进与基线时较低的 WMT-Q 分数相关，而 PWC 用户的能力和性能改进与基线分数无关。以结构化小组形式提供这种培训的成本较低，因此可能会提高临床实践的采用率。
To assess the effectiveness of group wheelchair maintenance training and investigate participant characteristics associated with responsiveness to training. Randomized control trial with an immediate group and waitlist control group (WLCG) who received the intervention after a 6-month delay. Four Spinal Cord Injury Model Systems Centers. Manual (MWC) and power wheelchair (PWC) users with spinal cord injury (n=80 and 67, respectively). Two 90-minute structured wheelchair maintenance training program classes with 12-20 people per class and separate classes for MWC and PWC users. Each class included in-person hands-on demonstrations and practice of wheelchair maintenance. Separate analysis was completed for MWC and PWC users using the Wheelchair Maintenance Training Questionnaire (WMT-Q) capacity (ability to complete), performance (frequency of completion) and knowledge at baseline, 1-month, 6-month, 6-month-pre-training (WLCG only), and 1-year (immediate only). Following the intervention, participants in both the immediate and WLCG improved in maintenance capacity (MWC and PWC, p<0.001) and performance (MWC and PWC, p<0.001) with training. Only PWC users improved knowledge of wheelchair maintenance (p<0.001). For both WLCGs (MWC and PWC) there was no difference between the 6-month-pre-training time-point and baseline. MWC users who responded to training had lower WMT-Q scores for all domains while for PWC users this was only the case for knowledge. Group wheelchair skills training is effective at improving capacity to complete maintenance and performance of maintenance activities for MWC and PWC users, even in a cohort of experienced wheelchair users. For MWC users improvements were tied to lower WMT-Q scores at baseline, while PWC users improved in capacity and performance independent of baseline score. Delivering this training in a structured group format is lower cost and therefore might improve adoption into clinical practice.
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