Training characteristics important for growing consciousness of joystick-use in people with profound cognitive disabilities

Abstract

Aim The Driving to Learn project focused on people with profound cognitive disabilities and their possible achievements from practicing joystick-use in a powered wheelchair. The aim of this study within the project was to statistically analyse the participants' outcomes, and to explore factors, in terms of participant and training characteristics, associated with a favourable outcome of training joystick-use. Methods In this study, previously collected and analysed data and findings from 45 participants (aged 12 months to 52 years) were used to extract participant and training characteristics. Associations between participant and training characteristics and the participant's outcome of joystick-use were calculated. Results The results showed that training characteristics were decisive for reaching steering control, whereas participant characteristics were not. Factors significantly associated with participant's reaching ‘control of steering’ were: taking part in more than 30 training sessions (p=0.004), training at two or more training venues (p=0.007), undergoing a training period longer than two years (p=0.016), and a high degree of training with professional trainers (p=0.045). Conclusions Appropriate training characteristics assisted growing consciousness of joystick-use in people with profound cognitive disabilities. Findings from the project also include the identification of an eight-phase process of growing consciousness of joystick-use and the development of a tool for assessment of phases, which were used to measure the participants outcome.

Driving to Learn in a Powered Wheelchair: The Process of Learning Joystick Use in People With Profound Cognitive Disabilities

“…The 6 participants with walking ability followed the same trajectory as the 39 participants without walking ability. The outcomes of the 45 participants, their individual characteristics, and the characteristics of facilitator training are described in more detail and statistically analyzed in Nilsson, Nyberg, and Eklund (2010).…”

Assessment of learning powered mobility use—Applying grounded theory to occupational performance

“…The ALP tool is an assessment tool that originated from two separate GT studies, both focused on discovering the process of learning powered mobility [1,[11][12][13][14][15][16][17][18]. The ALP tool is grounded in extensive data taken from a number of sources including a wide group of participants over an extensive period of time.…”

“…Focus for using the ALP tool is to understand where the learner is in the process and provide appropriate facilitation in addition to recognizing changes and achievements. The interrater reliability study of Nilsson et al's previous eight-phase assessment tool [18] showed a very good weighted kappa value (0.85), and that tool also showed responsiveness to change when it was used to assess the outcome of her 45 powered wheelchair learners with profound cognitive disabilities [1]. A study of the intra-and interrater reliability of the ALP instrument, as well as of its responsiveness to change, would strengthen the scientific evidence of its use in clinical practice.…”

“…Powered mobility use is an area of occupational performance that develops as a result of practice [1]. Occupational performance is defined as "the ability to perceive, desire, recall, plan and carry out roles, routines, tasks and sub-tasks for the purpose of self-maintenance, productivity, leisure and rest in response to demands of the internal and/or external environment" [2].…”

“…Nilsson also carried out GT research [1,[14][15][16][17][18]: her work focused on people with profound cognitive disabilities from several age groups. Nilsson studied what this population could achieve from practice in a powered wheelchair.…”