Category: Spinal Cord Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : Test the feasibility of a repetition-based overground wheelchair propulsion training program based on Clinical Practice Guidelines (CPGs).
Design : Randomized controlled trial
Setting : Controlled laboratory space and a community center.
Participants (or Animals, Specimens, Cadavers) :
Eight manual wheelchair users with spinal cord injuries were randomized into the control group (CG) or the training group (TG). Eligible participants displayed non-CPG-based propulsion patterns during the Wheelchair Propulsion Test (WPT) or a 6-minute push test.
Both groups received basic education regarding CPG-recommended biomechanically efficient wheelchair propulsion techniques using video and instruction materials. The TG received six additional one-hour training sessions across three weeks. Participants worked with trained staff, focusing on achieving 6000 pushes based on CPG recommendations by the end of the training program.
Main Outcome Measure(s) :
The number of CPG-based propulsion counts during training. Both groups received three assessments at approximately 3 weeks in-between each assessment. Video motion analysis was used to measure push angle and relationship of the hand to the axle during the recovery phase. The WPT was used during the intervention and assessments to assess push efficiency. Video recording was used to assess propulsion patterns outdoors.
Seventy-five percent of TG participants achieved 6000 CPG-based propulsions. One TG participant who did not achieve the goal also did not show improvement in propulsion patterns. Three TG participants showed visible changes in propulsion patterns at the second assessment. One CG participant performed sporadic CPG-based propulsions within the second assessment. No changes observed for all other CG participant.
Results indicate that 6000 repetitions of CPG-based propulsion are feasible for participants across 6 sessions. Training seems to provide consolidation of propulsion skills. We aim to increase the sample size.