Cher Smith

Our primary objective was to assess wheelchair service providers' opinions on manual wheelchair-skills courses ("bootcamps"). Our secondary objective was to test the hypothesis that these courses enhance the learners' self-reported capacity and confidence. This was an observational study that took place in rehabilitation and conference centers on 407 wheelchair service providers each of whom took part in one of 26 practical workshops on manual wheelchair skills at least 1 day in duration. Post-course, all participants completed a Course Evaluation Form with ordinal (1-5), categorical, and free-response questions. A subset of 103 participants also completed a modified Wheelchair Skills Test Questionnaire (WST-Q) of "capacity" and "confidence". The percentages of participants who answered 5 ("extremely so") to the questions "useful?", "relevant?", "well-tolerated?", "understandable?", and "enjoyable?" were 94.1, 90.4, 92.6, 95.6, and 97.3%. The median for the Overall Satisfaction Score (OSS) (1-5) of the 26 bootcamps was 4.96. Most participants (87.1%) considered the course "just right" in duration, and (100%) stated that they would recommend the Course to others. There were numerous qualitative comments about the course content, as well as what participants found most and least useful. Over half of the WST-Q respondents reported improvements in capacity and confidence in 26 (90.0%) and 25 (86.2%) of individual skills. Although there is room for improvement, wheelchair service providers were generally positive about in-person courses, and the courses enhance wheelchair-skills capacity and confidence.

In this single-blind randomized controlled trial, we tested the hypotheses that, in comparison with control participants receiving only self-study materials (SS group), caregivers of manual wheelchair users who additionally receive remote training (RT group) have greater total Wheelchair Skills Test Questionnaire (WST-Q) performance and confidence scores post-training and at follow-up; and that self-study and remote training each individually lead to such gains. We studied 23 dyads of wheelchair users and their caregivers. Caregivers in the SS group received a handbook and videorecording. Those in the RT group also received up to four real-time ("synchronous") sessions remotely. The WST-Q 5.1 was administered pre-training (T1), post-training (T2), and after a 3-month follow-up (T3). The mean total WST-Q scores of both groups rose slightly at each new assessment. For the T2-T1 and T3-T1 gains, there were no statistically significant differences between the groups for either WST-Q performance or WST-Q confidence. For performance, the T2-T1 gain was statistically significant for the RT group and the T3-T2 gain was statistically significant for the SS group. For both groups, the T3-T1 gains in performance were statistically significant with gains of 12.9% and 18.5% relative to baseline for the SS and RT groups. For confidence, only the T3-T1 gain for the SS group was statistically significant with a gain of 4.5% relative to baseline. Although less than the gains previously reported for in-person training, modest but important gains in total WST-Q performance scores can be achieved by self-study, with or without remote training. NCT03856749.

PurposeTo test the hypothesis that a Remote-Learning Course improves the subjective wheelchair-skills performance and confidence of wheelchair service providers, and to determine the participants' views on the Course.MethodsThis was an observational cohort study, with pre-post comparisons. To meet the objectives of the six-week Course, the curriculum included self-study and weekly one-hour remote meetings. Participants submitted their Wheelchair Skills Test Questionnaire (WST-Q) (Version 5.3.1) "performance" and "confidence" scores before and after the Course. Participants also completed a Course Evaluation Form after the Course.ResultsThe 121 participants were almost all from the rehabilitation professions, with a median of 6 years of experience. The mean (SD) WST-Q performance scores rose from 53.4% (17.8) pre-Course to 69.2% (13.8) post-Course, a 29.6% relative improvement (p < 0.0001). The mean (SD) WST-Q confidence scores rose from 53.5% (17.9) to 69.5% (14.3), a 29.9% relative improvement (p < 0.0001). Correlations between performance and confidence were highly significant (p < 0.0001). The Course Evaluation indicated that most participants found the Course useful, relevant, understandable, enjoyable, "just right" in duration, and most stated that they would recommend the Course to others.ConclusionsAlthough there is room for improvement, a Remote-Learning Course improves the subjective wheelchair-skills performance and confidence scores of wheelchair service providers by almost 30%, and participants were generally positive about the Course.

To test the hypotheses that, in comparison with pushing an occupied upright manual wheelchair forward, pulling backward on the push-handles improves the objective and subjective ease with which a c... Caregivers should pull rather than push occupied manual wheelchairs across soft surfaces.In the forward direction, caregivers may find the wheelie position easier than and preferable to the upright...

To explore the experiences of new motorised mobility scooter users from the perspectives of the assessment and training of scooter skills.Descriptive secondary analysis of qualitative data.Communit...

To determine the extent to which wheelchair service providers conduct wheelchair-skills training, the nature of training, and the providers’ perceptions on training.Anonymous global online survey c...

This study assessed the effectiveness of a learning module we developed for planning students aimed to enhance their understanding for design issues in public spaces faced by wheelchair users. The module involves training of students to effectively navigate the environment in a wheelchair before they experience the real outdoor spaces. Through this evaluation study, we also attempted to add clarity to the problems observed from empirical studies about these ‘try-it-yourself’ exercises, such as potential stigmatisation and ableism. We employed a mixed-method study approach consisting of wheelchair skill tests, ‘walkabout’ audits, and a focus group, with 28 second-year undergraduate urban planning students. The cross-over design of the study involving two components of the module – (wheelchair) Skill Learning Experience (SLE) and Real-World Experience (RWE) – allowed us to assess the effect of the former on the performance of the latter and the module overall. The focus group also asked students’ perspectives about the module. Our findings suggest that the wheelchair skills training component likely contributed to a more nuanced and comprehensive understanding of design problems, while also fostering respect for wheelchair users. We believe that careful implementation is key to addressing potential negative consequences while optimising the benefit of experiential exercises.

Purpose: The aim of this study was to test the hypotheses that, during manual-wheelchair foot propulsion backward on a soft surface, lowering the seat height increases speed, push frequency and push effectiveness, and decreases perceived difficulty. Materials and methods: In a repeated-measures crossover study, 50 able-bodied participants used one foot to propel a manual wheelchair 5 m backward on a soft surface at 5 seat heights, ranging from 5.08 cm below to about 5.08 cm above lower-leg length, in random order. We recorded Wheelchair Skills Test (WST) capacity scores and used the Wheelchair Propulsion Test (WPT) to calculate speed (m/s), push frequency (cycles/s) and push effectiveness (m/cycle). We also recorded the participants’ perceived difficulty (0–4) and video-recorded each trial. Results: WST capacity scores were reduced at the higher seat heights. Using repeated-measures models (adjusted for age, sex and order), there were negative relationships between seat height and speed (p < 0.0001) and push effectiveness (p < 0.0001). Lowering the seat height by 5.08 cm below lower-leg length corresponded to improvements in speed of 0.097 m/s and in push effectiveness of 0.101 m/cycle. The trend for push frequency was also significant (p = 0.035) but the effect size was smaller. Perceived difficulty increased with seat height (p < 0.0001). The video-recordings provided qualitative kinematic data regarding the seated “gait cycles”. Conclusions: During manual-wheelchair foot propulsion backward on a soft surface, lowering the seat height increases speed and push effectiveness, and decreases perceived difficulty.

Purpose: To determine the extent to which Occupational Therapists (OTs) in Nova Scotia (NS) conduct wheelchair skills training, the nature of training and the OTs’ perceptions on training. Materials and methods: Anonymous online survey. Results: We received 110 responses from OTs living in NS and involved in direct patient care, 96 (93%) of whom reported helping clients obtain manual wheelchairs. Of the OTs who responded to the question “…do you typically provide wheelchair-skills training…?”, 40 (43.5%) answered “Yes, usually” for clients and 40 (46.0%) for caregivers. The median duration of training sessions for clients and caregivers was 30 and 20 min; the median number of sessions was 2 and 1. Regarding the importance of training, 65 (73.9%) OTs answered “Very important” and 22 (25%) “Somewhat important” for clients and 55 (64.0%) answered “Very important” and 29 (33.7%) “Somewhat important” for caregivers. About one-third of OTs considered themselves adequately prepared for the trainer role. A variety of barriers and facilitators to training were identified. Trainers were significantly more likely than non-trainers to consider wheelchair skills training as important (p = .0003 for clients and p = .0039 for caregivers) and to consider themselves adequately prepared for the trainer role (p = .002 for clients and .003 for caregivers). Conclusions: Only a minority of NS OTs usually provide wheelchair-skills training for clients or their caregivers and the training provided is minimal, despite a majority who consider such training to be important. Only about one-third of OTs feel prepared for the training role.

Purpose: To test the hypotheses that, during manual wheelchair foot propulsion forward on smooth level surfaces, lowering the seat height increases speed, push frequency and push effectiveness, and decreases perceived difficulty. Materials and methods: In a repeated-measures crossover study, 50 able-bodied participants used one foot to propel a manual wheelchair 10 m on a smooth level surface at 5 seat heights in random order, ranging from 5.08 cm below to about 5.08 cm above lower-leg length. We recorded Wheelchair Skills Test (WST) capacity scores and used the Wheelchair Propulsion Test (WPT) to calculate speed (m/s), push frequency (cycles/s) and push effectiveness (m/cycle). We also recorded the participants’ perceived difficulty (0–4) and video-recorded each trial. Results: WST capacity scores were reduced at the higher seat heights. Using repeated-measures models (adjusted for age, sex and order), there were negative relationships between seat height and speed (p < 0.0001) and push effectiveness (p < 0.0001). Lowering the seat height by 5.08 cm below lower-leg length corresponded to improvements in speed of 0.20 m/s and in push effectiveness of 0.20 m/cycle. The trend for push frequency was also significant (p = 0.003) but the effect size was smaller. Perceived difficulty increased with seat height (p < 0.001). The video-recordings provided qualitative kinematic data regarding the seated “gait cycles”. Conclusions: During manual wheelchair foot propulsion forward on smooth level surfaces, lowering the seat height increases speed and push effectiveness, and decreases perceived difficulty. Clinical Trial Registration Number: NCT03330912.