Efficacy and retention of the French-Canadian version of the wheelchair skills training program for manual wheelchair users: a randomized controlled trial

Abstract

Objectives: To test the hypotheses that, in comparison with a control group that received standard care, users of manual wheelchairs who also received the French-Canadian version of the Wheelchair Skills Training Program (WSTP) would significantly improve their wheelchair-skills capacity and that these improvements would be retained at 3 months.

Design: Multicenter, single-blind, randomized controlled trial.

Setting: Three rehabilitation centers in Montréal, Quebec, Canada.

Participants: Manual wheelchair users (N=39), a sample of convenience.

Intervention: Participants were randomly allocated to the WSTP or control groups. Participants in both groups received standard care. Participants in the WSTP group also received a mean of 5.9 training sessions (a mean total duration of 5h and 36min).

Main outcome measures: The French-Canadian version of the Wheelchair Skills Test (WST) (Version 3.2) was administered at evaluation at first time period (baseline) (t1), evaluation at second time period (posttraining) (t2) (a mean of 47d after t1), and at evaluation at third time period (follow-up) (t3) (a mean of 101d after t2).

Results: At t2, the mean ± SD total percentage WST capacity scores were 77.4%±13.8% for the WSTP group and 69.8%±18.4% for the control group (P=.030). Most of this difference was due to the community-level skills (P=.002). The total and subtotal Wheelchair Skills Test scores at t3 decreased by ≤0.5% from the t2 values, but differences between groups at t3, adjusting for t1, did not reach statistical significance (P≥.017 at a Bonferroni-adjusted α level of .005).

Conclusion: WSTP training improves wheelchair skills immediately after training, particularly at the community-skills level, but this study did not show statistically significant differences between the groups at 3 months.

Trial registration: ClinicalTrials.gov NCT00400244.

Figure 1

Flow diagram reflecting participant involvement.

Figure 2

Total and Subtotal WST Scores plotted against time. A. Total WST scores. B. Indoor-level WST scores. C. Community-level WST scores. D. Advanced-level WST scores. For 2A, 2B and 2C, the mean and standard deviation values are shown. For 2D, the median value is shown because the data were non-normal. T1 represents the baseline evaluation, T2 is the evaluation followed training (~47 days after T1). T3 is the follow-up evaluation (~101 days after T2). * indicates statistical significance (p = 0.0296 for Figure 2A and p = 0.0018 for Figure 2C).

Figure 2

Total and Subtotal WST Scores plotted against time. A. Total WST scores. B. Indoor-level WST scores. C. Community-level WST scores. D. Advanced-level WST scores. For 2A, 2B and 2C, the mean and standard deviation values are shown. For 2D, the median value is shown because the data were non-normal. T1 represents the baseline evaluation, T2 is the evaluation followed training (~47 days after T1). T3 is the follow-up evaluation (~101 days after T2). * indicates statistical significance (p = 0.0296 for Figure 2A and p = 0.0018 for Figure 2C).

Figure 2

Total and Subtotal WST Scores plotted against time. A. Total WST scores. B. Indoor-level WST scores. C. Community-level WST scores. D. Advanced-level WST scores. For 2A, 2B and 2C, the mean and standard deviation values are shown. For 2D, the median value is shown because the data were non-normal. T1 represents the baseline evaluation, T2 is the evaluation followed training (~47 days after T1). T3 is the follow-up evaluation (~101 days after T2). * indicates statistical significance (p = 0.0296 for Figure 2A and p = 0.0018 for Figure 2C).

Figure 2

Total and Subtotal WST Scores plotted against time. A. Total WST scores. B. Indoor-level WST scores. C. Community-level WST scores. D. Advanced-level WST scores. For 2A, 2B and 2C, the mean and standard deviation values are shown. For 2D, the median value is shown because the data were non-normal. T1 represents the baseline evaluation, T2 is the evaluation followed training (~47 days after T1). T3 is the follow-up evaluation (~101 days after T2). * indicates statistical significance (p = 0.0296 for Figure 2A and p = 0.0018 for Figure 2C).