A motor learning approach to training wheelchair propulsion biomechanics for new manual wheelchair users: A pilot study

Morgan, Kerri; Tucker, Susan; Klaesner, Joseph W.; Engsberg, Jack R.

doi:10.1080/10790268.2015.1120408

Cited by 17 publications

(8 citation statements)

References 52 publications

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“…Propulsion technique did not change significantly across active rehabilitation in the group with a recent SCI and there were no significant differences in technique between the groups with a recent and long-term SCI. Moreover, the overall values of frequency and contact angle in both groups resembled those reported in other studies with experienced wheelchair users with a SCI [24,[26][27][28][29]. These findings support the earlier discussion point that at least some of the improvement in the propulsion technique in the group with a recent SCI could have taken place before the onset of the study.…”

Section: Comparison Between the Participants With A Recent Sci And Exsupporting

confidence: 89%

Motor learning outcomes of handrim wheelchair propulsion during active spinal cord injury rehabilitation in comparison with experienced wheelchair users

Leving

Groot

Woldring

et al. 2019

Disability and Rehabilitation

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Purpose: To investigate changes in wheelchair propulsion technique and mechanical efficiency across first five weeks of active inpatient spinal cord injury rehabilitation and to compare the outcomes at discharge with experienced wheelchair users with spinal cord injury. Methods: Eight individuals with recent spinal cord injury performed six weekly submaximal exercise tests. The first and last measurement additionally contained a wheelchair circuit and peak graded exercise test. Fifteen experienced individuals performed all above-mentioned tests on one occasion. Results: Mechanical efficiency and propulsion technique did not change during the five weeks of inpatient rehabilitation. Peak power output during peak graded test and performance time on the wheelchair circuit improved between the first and the last week. No difference in propulsion technique, peak power output, and performance time was found between the persons with a recent injury and the experienced group. Mechanical efficiency was higher after the correction for the difference in relative power output in the experienced group. Conclusion: The group with a recent injury did not improve mechanical efficiency and propulsion technique over the period of active rehabilitation, despite significant improvements on the wheelchair circuit and in work capacity. The only significant difference between the groups was found in mechanical efficiency. ä IMPLICATIONS FOR REHABILITATION The lack of time-dependent changes in mechanical efficiency and propulsion technique in the group with a recent spinal cord injury, combined with the lack of differences in technique, work capacity and on the wheelchair circuit between the groups, suggest that important adaptations of motor learning may happen even earlier in rehabilitation and emphasize that the group in active rehabilitation was relatively skilled. Standardized observational analyses of handrim wheelchair propulsion abilities during early spinal cord injury rehabilitation provide detailed understanding of wheelchair technique, skill as well as wheelchair propulsion capacity. Measurement of external power output is critical to interpretation of gross efficiency, propulsion technique, and capacity. Wheelchair quality and body weightnext to wheelchair fitness and skillrequire careful consideration both in early rehabilitation as well as in the chronic phase of spinal cord injury.

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Section: Comparison Between the Participants With A Recent Sci And Exsupporting

confidence: 89%

Motor learning outcomes of handrim wheelchair propulsion during active spinal cord injury rehabilitation in comparison with experienced wheelchair users

Leving

Groot

Woldring

et al. 2019

Disability and Rehabilitation

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“…The WSTP is a set of training protocols that combines the best available evidence on motor-skills learning with the best evidence on how to perform specific wheelchair skills. There are a growing number of randomized controlled trials (RCTs) that provide evidence for the safety and effectiveness of the WSTP in a variety of settings [27–32] as well as other evidence about the benefits of wheelchair-skills training [33–35]. There is also growing evidence for a relationship between wheelchair skills and other important outcomes such as confidence and participation [2,3,4,21,22,31,36–39].…”

Section: Introductionmentioning

confidence: 99%

Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial

et al. 2016

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ObjectivesTo test the hypotheses that community-dwelling veterans with spinal cord injury (SCI) who receive the Wheelchair Skills Training Program (WSTP) in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC) group.MethodsWe carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30–45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST) and Craig Handicap Assessment and Reporting Technique (CHART) scores.ResultsParticipants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001) and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021).ConclusionsIndividualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.

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“…The initial search resulted in 1225 hits (Figure 1). After applying the inclusion and exclusion criteria, 10 RCTs 2,4–6,8,9,19–22 and seven non-randomized studies 23–29 involving a total of 595 participants were eligible and included in the systematic review. Supplementary Table 1 summarizes the basic characteristics of all controlled clinical trials.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review

Liu

Wang

et al. 2017

Clin Rehabil

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A motor learning approach to training wheelchair propulsion biomechanics for new manual wheelchair users: A pilot study

Cited by 17 publications

References 52 publications

Motor learning outcomes of handrim wheelchair propulsion during active spinal cord injury rehabilitation in comparison with experienced wheelchair users

Motor learning outcomes of handrim wheelchair propulsion during active spinal cord injury rehabilitation in comparison with experienced wheelchair users

Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial

Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review

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