|
BACKGROUND/RATIONALE:
Enhancing Indoor, Community, and Advanced Wheelchair Skills in SCI
Audrey Nelson, PhD - PI
The wheelchair is among the most common and important of rehabilitation devices, particularly for persons with mobility impairments, including persons with a spinal cord injury (SCI). Despite advances in wheelchair technology, users continue to face significant limitations to mobility and increased risk associated with falls and over-use injuries of the upper extremities. Mobility limitations arise as a result of environmental barriers (e.g., rough terrain, stairs, or steep inclines). In order to deal with these barriers, manual wheelchair users need to develop a set of specific wheelchair skills (e.g., turning around in tight spaces or negotiating a curb). Without these critical skills, wheelchair users may avoid these obstacles altogether, significantly limiting mobility, community participation, and independence in daily life.
OBJECTIVE(S):
Rationale and Objectives: The purpose of this study is to evaluate use of Wheelchair Skills Training Program for patients with spinal cord impairment (SCI) who use a manual wheelchair. Our immediate objectives include: 1) Determine the immediate and sustained effects of a wheelchair skills training on ability, performance time, and physical strain. 2) Examine the effects of mediating and moderating variables on ability, performance time, and physical strain 3) Examine the effects of wheelchair skills training on safety, community participation, and quality of life. 4) If successful, promote dissemination of the wheelchair skills training in VA SCI Centers.
METHODS:
Research Design & Methods: A two group randomized placebo controlled design will be used. Veterans with SCI will be assigned randomly to either the WSTP group or an education control (EC) group. Data will be collected over three points in time: baseline, immediately post-intervention (1 month), and 12 months post intervention.
Data Source: Data will be collected through direct observation, questionnaires, medical record review, and qualitative interviews. Baseline and subsequent data will consist of self-reported survey data, wheelchair skills test administered by a clinician, and analysis of their physical strain completed by using the SMARTWheel. Baseline data will also include a Medical Record review. Bi-monthly phone calls will be made to collect information about the wheelchair tips and falls. Qualitative data collection will be done at 1 and 12 month post-intervention. Logs in the electronic medical records and patient maintained logs will be used to collect cost related data.
FINDINGS/RESULTS:
This project just initiated recruitment, therefore, no project findings are reported
IMPACT:
Anticipated Impact: This study will be one of the first to address modifiable risk factors contributing to morbidity and mortality associated with long term wheelchair use. Optimal use of wheelchairs is hampered by inadequate training. At the end of this study, we will be able to provide the following products: 1. Evidence-based recommendations for incorporation of wheelchair skills testing and training as part of the life-long SCI continuum of care offered by the VA. Data from this study will provide a basis for both VA and non-VA administrators and clinicians to make policy and practice changes. 2. The study will provide estimated costs of adding wheelchair skills testing to the SCI annual evaluation and the SCI system of care, providing an economic basis for policy and practice change. 3. Data on patient perceived benefits of participating in wheelchair skills training will facilitate design of interventions likely to be accepted by wheelchair users. 4. Innovative marketing plans to increase patient participation and promote patient-centeredness based on patient-perceived benefits will be developed 5. Findings will be exported throughout the VHA through the Chief Consultant for Spinal Cord Injury and Disorders Strategic Healthcare Group, National Consortium for Spinal Cord Injury Medicine Clinical Practice Guidelines, and the SCI QUERI.
PUBLICATIONS:
None at this time.
DRA:
Acute and Traumatic Injury, Health Services and Systems, Military and Environmental Exposures
DRE:
Rehabilitation, Technology Development and Assessment, Prevention
Keywords:
Adverse events, Safety, Spinal cord injury
MeSH Terms:
none
|
