Enhancing Indoor, Community, and Advanced Wheelchair Skills in Spinal Cord Injury (SCI)

US Department of Veterans Affairs (VA)

Status and phase: Completed; Phase 3; Phase 2

Conditions: Spinal Cord Injury

Treatments: Behavioral: Wheelchair Skills Training; Behavioral: Basic Health Education

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT00434018

IIR 06-274

Details and patient eligibility

About

We propose to test an evidence-based wheelchair skills training program to optimize wheelchair safety and performance in veterans with SCI. The proposed training program incorporates emerging evidence on wheelchair biomechanics and motor-skills learning, and addresses recommendations in a new clinical practice guideline. Given the difficulty in translating wheelchair skills learned in a therapy clinic with "real world" problems in the home and community post-discharge, we are proposing to conduct the wheelchair skills training in and around the veteran's home. The immediate goal is to enhance ability, performance time, safety, community participation, and quality of life, while minimizing physical strain. The ultimate goal is to reduce morbidity/mortality associated with wheelchair use and promote successful aging with a disability.

Full description

The purpose of this 3-year randomized controlled clinical trial is to evaluate use of a community-based wheelchair skills training program (WSTP). Objectives include:

1. Determine the immediate and sustained effects of a WSTP 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 a WSTP on safety, community participation, and quality of life.
4. Promote dissemination of WSTP in VA SCI Centers through two key activities: (a) Design innovative marketing plans to increase participation and promote patient-centeredness based on patient-perceived benefits. (b) Estimate health care resources needed to add home-based

Enrollment: 138 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• SCI for at least 1 year (neurologically stable)
• Level of injury: C6 and below who use manual wheelchair as a primary means of mobility
• Able to self-propel wheelchair
• Between the ages of 18-75
• Able to follow simple instructions

Exclusion criteria

• Progressive disease (e.g. spinal tumor)
• Extended bedrest for more than 30 days
• Ventilator-dependent
• Any cardiac or respiratory condition that would limit subject's physical performance
• Unstable medical conditions
• Use power wheelchair or scooter as primary means of mobility
• Pregnancy

Trial design

138 participants in 2 patient groups

Wheelchair Skills Training Program

Other group

Description:

Subjects are provided with five weeks of wheelchair skills training, tailored to meet their needs. The WSP is a set of assessment and training protocols related to wheelchair skills. The WSP includes the Wheelchair Skills Test (WST), the Wheelchair Skills Training Program (WSTP) and related materials.

Treatment:

Behavioral: Wheelchair Skills Training

Basic Health Education

Other group

Description:

Basic health educational training sessions: Five sessions are held with subjects to provide them additional information regarding health related issues - such as nutrition, proper hand hygiene, sports, etc.

Treatment:

Behavioral: Basic Health Education