Best Krista L, Kirby R Lee, Smith Cher, MacLeod Donald A
School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.
Arch Phys Med Rehabil. 2005 Dec;86(12):2316-23. doi: 10.1016/j.apmr.2005.07.300.
To test the hypotheses that wheelchair skills training of community-based manual wheelchair users is efficacious, safe, and practical.
Randomized controlled trial.
Rehabilitation center and community.
Twenty community-based manual wheelchair users (15 men, 5 women; age range, 21-77 y), half with musculoskeletal and half with neurologic disorders.
Participants were randomly allocated to the Wheelchair Skills Training Program (WSTP) or control groups. In 1-hour individualized sessions, the WSTP group participants received a mean +/- standard deviation of 4.5+/-0.7 hours of training. Caregivers participated whenever possible. In addition to training at the rehabilitation center, the trainer traveled to administer training in the community.
Using the Wheelchair Skills Test (WST, version 3.1), an objective test of 57 skills, we calculated total and subtotal percentage scores (percentage number of skills passed of those possible) and individual skill success rates.
The WSTP group's improvement in total WST score was significantly greater than the control group's (P<.005). The mean total WST score for the WSTP group increased from a pretraining value of 63.3%+/-6.0% to 78.5%+/-8.3% posttraining, a relative improvement of 24.0% (P=.002). The control group increased from a baseline value of 70.8%+/-14.0% to 74.2%+/-11.8% at follow-up, a relative improvement of 4.8% (P=.03). The WSTP group had clinically significant pre- and posttraining improvements (> or = 20%) in the success rates of 25 of the 57 individual WST skills, compared with only 5 skills for the control group. There were no adverse incidents, and the WSTP participants' comments were all positive.
Wheelchair skills training of community-based manual wheelchair users is efficacious, safe, and practical. These findings have implications for the standard of rehabilitation care.
验证关于社区手动轮椅使用者的轮椅技能训练有效、安全且实用的假设。
随机对照试验。
康复中心和社区。
20名社区手动轮椅使用者（15名男性，5名女性；年龄范围21 - 77岁），其中一半患有肌肉骨骼疾病，另一半患有神经系统疾病。
参与者被随机分配至轮椅技能训练项目（WSTP）组或对照组。在为期1小时的个性化课程中，WSTP组参与者平均接受了4.5±0.7小时的训练。护理人员尽可能参与其中。除了在康复中心进行训练外，培训师还前往社区进行培训。
使用轮椅技能测试（WST，3.1版），这是一项对57项技能的客观测试，我们计算了总分和分项得分百分比（通过的技能数量占可能通过的技能数量的百分比）以及各项技能的成功率。
WSTP组在WST总分上的改善显著大于对照组（P <.005）。WSTP组的平均WST总分从训练前的63.3%±6.0%提高到训练后的78.5%±8.3%，相对提高了24.0%（P =.002）。对照组从基线值70.8%±14.0%提高到随访时的74.2%±11.8%，相对提高了4.8%（P =.03）。WSTP组在57项WST单项技能中有25项的成功率在训练前后有临床显著改善（≥20%），而对照组只有5项技能有改善。未发生不良事件，WSTP参与者的反馈均为积极。
社区手动轮椅使用者的轮椅技能训练有效、安全且实用。这些发现对康复护理标准具有启示意义。
