The objective of this study is to determine the effectiveness of remote manual wheelchair skills training program for clinicians. The study will use three-group approach: intervention with remote feedback (Group 1), control group (Group 2), and structured self-study (Group 3). This demonstrates how the intervention compares not only to a control, but also to the next "best alternative" - therapists sourcing web-based training materials and learning independently.
A randomized, single-blinded, two-period cross-over study design for Groups 1 and 2 will be used. Participants will complete baseline assessments and then be randomized to either Group 1 or Group 2. After enrollment for Groups 1 and 2 is completed, Group 3 participants will be enrolled. Group 1 will receive the active intervention (intervention A) which will include a two-part training in wheelchair skills. For Part 1, they will review approximately 4 hours of educational videos on how to complete and teach wheelchair skills. For Part 2 they will complete a practice-feedback loop with a remote trainer providing asynchronous feedback. Group 3 will mirror Group 1 but complete only Part 1 of the training. Group 2 will receive the control intervention (intervention B) participants will review approximately 4 hours of educational videos. Participants will have 8 weeks to complete either training program. Both groups will then complete follow-up at 2 and 6 months. Following this, participants will cross over to receive the other intervention (Group 1 and 3 will receive intervention B, Group 2 will receive intervention A) and complete follow-up at 8 and 12 months. Additionally, rehabilitation professionals who are not therapists will be able to access the training through a structured self-study (Group 4). This group will receive access to both trainings with follow-up at 2 and 6 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
Clinicians will review a suite of training videos in a prescribed order that discuss motor learning principles, safe spotting, and how to complete 15 intermediate and advanced skills: 1. Opening/closing doors 2. getting over a gap 3. getting over a threshold 4. ascending a low curb 5. descending a low curb 6. ascending a high curb 7. descending a high curb 8. performing a stationary wheelie 9. descending a high curb in a wheelie position 10. descending a steep incline in a wheelie position and stopping 11. ascending stairs 12. descending stairs 13. completing a floor-to-chair transfer 14. car transfers 15. folding and unfolding wheelchair
Participants will practice of wheelchair skills paired with remote feedback. Participants will be reminded to practice once per week. The participant will practice any number of the 15 skills for a self-selected duration. Following each practice session, the participant will upload video(s) of the skills practiced and a session log, indicating any difficulties they encountered. The remote trainer will then review the video-recordings and reply to the participant with feedback.
University of Pittsburgh / Rehab Neural Engineering Labs
Pittsburgh, Pennsylvania, United States
Change in Wheelchair Skills Test Questionnaire (WST-Q) score
Clinician capacity and confidence to complete wheelchair skills, as measured by wheelchair skills test questionnaire (WST-Q), will improve following training (Group 1,3) compared to the active control group (Group 2). The WST-Q includes values from 0-3 for each of Capacity, Confidence, and Performance. These three scores will be averaged. A higher value indicates a better outcome.
Time frame: baseline vs. 2 months
Change in Self-Efficacy on Assessing, Training, and Spotting (SEATS) score
Clinician confidence to provide wheelchair skills training, as measured by the Self-Efficacy on Assessing, Training, and Spotting (SEATS), will improve following training (Group 1,3) compared to the active control group (Group 2). The SEATS evaluation rates Assessing, Training, and Spotting, on scales from 0-5 for each skill. The values will be combined and averaged to assess progress over time. A higher score indicates improvement.
Time frame: baseline vs. 2 months
Change in number of wheelchair users trained
Clinician training of wheelchair users will increase in quantity (number of wheelchair users trained, duration of training) in the six months following training (Group 1,3) compared to the active control group (Group 2).
Time frame: baseline vs. 6 months
Change in quality of wheelchair skills trained
Clinician training of wheelchair users will increase in quality (number of wheelchair skills trained, capacity of trainees) in the year following training (Group 1,3) compared to the active control group (Group 2).
Time frame: baseline vs. 6 months
Change in rehab professional Wheelchair Skills Test Questionnaire (WST-Q) score
Rehabilitation professional capacity and confidence to complete wheelchair skills, as measured by wheelchair skills test questionnaire (WST-Q), will improve following training. The WST-Q includes values from 0-3 for each of Capacity, Confidence, and Performance. These three scores will be averaged. A higher value indicates a better outcome.
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Participants will be provided with access to web-based wheelchair provision education modules. When the content is viewed will be self-selected by participants. Participants will be asked to complete a feedback survey at the end of the modules. Participants will receive weekly reminders to complete the intervention until a feedback survey completed.
Time frame: baseline vs. 2 months, 6 months, and 1 year (Group 1,3 only) following training
Change in rehab professional Self-Efficacy on Assessing, Training, and Spotting (SEATS) score
Rehabilitation professional confidence to provide wheelchair skills training, as measured by the Self-Efficacy on Assessing, Training, and Spotting (SEATS), will improve following training. The SEATS evaluation rates Assessing, Training, and Spotting, on scales from 0-5 for each skill. The values will be combined and averaged to assess progress over time. A higher score indicates improvement.
Time frame: baseline vs. 2 months, 6 months, and 1 year (Group 1,3 only) following training
Change in rehab professional quantity of wheelchair users trained
Rehabilitation professional training of wheelchair users will increase in quantity (number of wheelchair users trained, duration of training) following training.
Time frame: baseline vs. 6 months, and 1 year (Group 1,3 only) following training
Change in rehab professional quality of wheelchair training
Rehabilitation professional training of wheelchair users will increase in quality (number of wheelchair skills trained, capacity of trainees) in the year following training.
Time frame: baseline vs. 6 months, and 1 year (Group 1,3 only) following training