Effect of an mHealth Wheelchair Skills Training Program for Older Adults: A Feasibility Randomized Controlled Trial

Edward M Giesbrecht; William C Miller

doi:10.1016/j.apmr.2019.06.010

Effect of an mHealth Wheelchair Skills Training Program for Older Adults: A Feasibility Randomized Controlled Trial

Arch Phys Med Rehabil. 2019 Nov;100(11):2159-2166. doi: 10.1016/j.apmr.2019.06.010. Epub 2019 Jul 20.

Authors

Edward M Giesbrecht¹, William C Miller²

Affiliations

¹ University of Manitoba, Rady Faculty of Health Sciences, College of Rehabilitation Sciences, Department of Occupational Therapy, Winnipeg, Manitoba, Canada. Electronic address: Ed.Giesbrecht@umanitoba.ca.
² University of British Columbia, Faculty of Medicine, Department of Occupational Science and Occupational Therapy, Vancouver, British Columbia, Canada.

PMID: 31336101
DOI: 10.1016/j.apmr.2019.06.010

Abstract

Objective: To evaluate the effect of an mHealth wheelchair skills training program on clinical outcomes among older adult manual wheelchair users.

Design: 2×2 factorial randomized controlled trial.

Setting: Community setting in 2 Canadian cities.

Participants: Convenience sample of manual wheelchair users 50 years and older living in the community who were able to self-propel with both hands and communicate in English. Participants (N=18) were randomized into either a mHealth treatment (n=10) or tablet gaming control (n=8) group.

Interventions: All participants received 2 in-person sessions with their trainer and engaged in a 4-week monitored home training program with a computer tablet. The Enhancing Participation In the Community by improving Wheelchair Skills program provided wheelchair skills training; the control program included 9 dexterity and cognitive training games.

Main outcome measures: The primary outcome was wheelchair skill capacity. Secondary outcomes included safety, self-efficacy, activity participation, mobility, divided-attention, and health-related quality of life.

Results: Data collection was blinded to group allocation. Capacity improved by 2 skills but with no statistically significant between-group difference. The mHealth training program had a significant effect on participation (P=.03) and self-efficacy (P=.06) with large effect sizes (η_p²=0.22-0.29). Mobility, safety with skill performance, and divided attention measures demonstrated medium effect size changes, but only safety with skill performance was statistically significant. The program was more beneficial for participants with <1 year of wheelchair experience.

Conclusion: Enhancing Participation In the Community by improving Wheelchair Skills participants demonstrated good program adherence and clinical benefits were evident in community participation and wheelchair self-efficacy. Wheelchair safety and mobility were positively affected, while skill capacity showed a small, nonsignificant improvement. Future study should investigate benefit retention over time.

Trial registration: ClinicalTrials.gov NCT01740635.

Keywords: Aged; Rehabilitation; Telemedicine; Telerehabilitation; Wheelchairs.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Canada
Disabled Persons / psychology
Disabled Persons / rehabilitation*
Feasibility Studies
Female
Humans
Male
Middle Aged
Motor Skills*
Patient Education as Topic / methods*
Patient Satisfaction
Quality of Life
Self Efficacy
Social Participation
Socioeconomic Factors
Telerehabilitation / methods*
Wheelchairs*

Associated data

ClinicalTrials.gov/NCT01740635

Grants and funding

MOP-123240/CIHR/Canada