Improving Clinician Capacity to Provide Interventions for Manual Wheelchair Users

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

235 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-22

Study Completion Date

2026-12-30

Brief Summary

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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.

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Detailed Description

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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.

Conditions

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Paraplegia Paralysis, Legs

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Randomized, single-blinded, two-period cross-over study design for Groups 1 and 2. Participants will complete baseline assessments and then be randomized to either Group 1 or Group 2. After enrollment for Groups 1 and 2 is complete, participants will be enrolled into Group 3.

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

For therapists, we will use a randomized, single-blinded, two-period cross-over study design for Groups 1 and 2. Participants will complete baseline assessments and then be randomized to either Group 1 or Group 2. After we have completed enrollment for Groups 1 and 2 we will enroll participants into Group 3.

Rehabilitation professionals who are not therapists will be enrolled in Group 4.

Study Groups

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Group 1: therapists

Group 1 will receive the active intervention (intervention A) of remote wheelchair skills training. They will cross-over to receive the control intervention (intervention B) of education on wheelchair provision at 6 months.

Group Type OTHER

Part 1 of intervention A - Wheelchair skills training modules

Intervention Type OTHER

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

Part 2 of intervention A - Asynchronous feedback from a remote trainer

Intervention Type OTHER

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.

Intervention B: Education on wheelchair provision

Intervention Type OTHER

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.

Group 2

Group 2 will complete the control intervention (intervention B) of education on wheelchair provision. They will cross-over to receive the active intervention (intervention A) of remote wheelchair skills training at 6 months.

Group Type OTHER

Part 1 of intervention A - Wheelchair skills training modules

Intervention Type OTHER

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

Part 2 of intervention A - Asynchronous feedback from a remote trainer

Intervention Type OTHER

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.

Intervention B: Education on wheelchair provision

Intervention Type OTHER

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.

Group 3

Groups 3 will mirror Group 1 but for intervention A will only complete Part 1 of the training and then be cued weekly to practice.

Group Type OTHER

Part 1 of intervention A - Wheelchair skills training modules

Intervention Type OTHER

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

Intervention B: Education on wheelchair provision

Intervention Type OTHER

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.

Group 4: rehab professionals, not therapists

Group 4 will mirror Group 3 but receive access to both interventions at the same time.

Group Type OTHER

Part 1 of intervention A - Wheelchair skills training modules

Intervention Type OTHER

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

Intervention B: Education on wheelchair provision

Intervention Type OTHER

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.

Interventions

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Part 1 of intervention A - Wheelchair skills training modules

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

Intervention Type OTHER

Part 2 of intervention A - Asynchronous feedback from a remote trainer

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.

Intervention Type OTHER

Intervention B: Education on wheelchair provision

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.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Practicing rehabilitation professional whose client population includes wheelchair users.
2. Willing and able to attempt practicing wheelchair skills
3. Access to a spotter(s)
4. Access to an Internet-ready device with video capabilities.
5. Speaks English

Exclusion Criteria

1\) Confident in teaching (Self-Efficacy on Assessing, Training, and Spotting \[SEATS\] item score = 5) and able to complete (WST-Q capacity item score = 2) \>50% of skills targeted by the training intervention.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No