Evaluation of the Wheelchair School (Drivkraft) a Clinical Study

Overview

This project will evaluate the Wheelchair School with the Drivkraft Methodology in a clinical setting. Participants are adults with chronic neurological diagnoses. For a person requiring a wheelchair, a well-functioning, individually adapted wheelchair and good maneuvering skills are essential for an independent daily life. These factors are also crucial in reducing the risk of secondary complications and pain. The Wheelchair School was founded in the 1990s, is provided by referral and both peer mentors and physiotherapists collaborate. It includes wheelchair prescription and adjustments, individually adapted wheelchair skills training, and theoretical lessons in group during 16 half-day sessions. The overarching aim is to evaluate the intervention Wheelchair school with the Drivkraft method, for wheelchair skills and patient safety for persons with chronic neurological diagnoses in a Swedish context. Also to evaluate the psychometric properties of the Drivkraft Manouevering Test (DWMT) for wheelchair skills.

Evaluation of the Wheelchair School using the Drivkraft Methodology This study focuses on adults with permanent neurological diagnoses (e.g., multiple sclerosis -MS, spinal cord injury) who continuously use a wheelchair. Education in a group setting with peer mentors who have personal experience of using a wheelchair, alongside interaction with other participants in similar situations, can be highly beneficial. The training program includes individual wheelchair prescription and or adjustments, wheelchair technique instruction, theoretical lessons, and group training. The program consists of 16 half-day sessions with peer mentors and physiotherapists in a clinical setting. Research questions: Do the participants improve in the following aspects directly after, and two months after the intervention: Wheelchair skills (WST and DWMT), satisfaction during everyday activities (Wheelchair Outcome Measure \[WhoM\]), confidence during everyday activities (Wheelchair confidence measure \[WCM\]), shoulder pain (wheelchair user shoulder pain index \[WUSPI\],fear and concerns about falling (Falls Concern Scale\[FCS\]), and number of falls and fall-related injuries? Is improvement of wheelchair skills associated with higher satisfaction and confidence, as well as decreased concerns about falling during daily activities? Does DWMT have sound psychometric properties, validity and sensitivity to change compared to WST? Method Design: A prospective intervention study with a comparison group. Participants: Adults with permanent neurological diagnoses referred to the Wheelchair School at Aleris Rehab Station, Stockholm, Sweden. The active comparison group comprises individuals with similar diagnoses in the same age range participating in other programs of similar length and intensity at the same unit. Procedure: All participants undergo a physiotherapy assessment, assessment of the wheelchair including settings and manouvering skills (DWMT, WST). Also, the participants answer patient reported outcome measures (WCM, WhOM, FCS), before, directly after the rehabilitation, and after two months. The active comparison group are assessed at the same time points with the same outcome measures. The program consists of 15 half-day training sessions, and a follow-up. Psychometric properties and validity of the DWMT will be assessed