Kirby R Lee, Bennett Sean, Smith Cher, Parker Kim, Thompson Kara
Division of Physical Medicine and Rehabilitation, Department of Medicine, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.
Arch Phys Med Rehabil. 2008 Dec;89(12):2342-8. doi: 10.1016/j.apmr.2008.04.028. Epub 2008 Nov 1.
Our primary objective was to test the hypothesis that a highly structured training method for wheelchair curb-climbing requires less training time than conventional training. Our secondary objectives were to test the hypotheses that this training method increases success rate, reduces the need for spotter interventions, and reduces the participants' perceptions of difficulty.
Randomized controlled trial.
Rehabilitation center.
Able-bodied participants (N=16), randomly allocated to intervention (n=7) and control (n=9) groups.
Both groups received up to 5 training sessions. Each session included instruction, practice, and feedback. The participants in the intervention and control groups used 18- and 9-step approaches, respectively. Training in the intervention group also included video demonstration, trainer demonstrations, mirror feedback, and standardized feedback phrases.
Total training time, success rate at climbing a 15 cm-high curb, the number of spotter interventions during training, and a questionnaire.
The mean+/-SD training times for the successful participants in the intervention and control groups were 42.5+/-24.4 minutes and 87.4+/-45.3 minutes (P=.084). The curb-climbing success rates of the intervention and control groups were 86% and 89% (P=1.000). There were no significant differences between the groups regarding the number of spotter interventions (P=.203) or for participants' perceptions of difficulty (P=.050).
In comparison with a conventional method for curb-climbing, a highly structured method seems to require less than 50% of the training time for able-bodied participants, although this finding is only a trend statistically. This has implications for clinical training.
我们的主要目的是检验这样一个假设，即针对轮椅上路边石的高度结构化训练方法比传统训练所需的训练时间更少。我们的次要目的是检验以下假设：这种训练方法能提高成功率、减少保护人员干预的需求，并降低参与者对难度的感知。
随机对照试验。
康复中心。
身体健全的参与者（N = 16），随机分为干预组（n = 7）和对照组（n = 9）。
两组均接受最多5次训练课程。每次课程包括指导、练习和反馈。干预组和对照组的参与者分别采用18步和9步方法。干预组的训练还包括视频演示、训练员示范、镜像反馈和标准化反馈语句。
总训练时间、爬上15厘米高路边石的成功率、训练期间保护人员干预的次数以及一份问卷。
干预组和对照组成功参与者的平均±标准差训练时间分别为42.5±24.4分钟和87.4±45.3分钟（P = 0.084）。干预组和对照组爬上路边石的成功率分别为86%和89%（P = 1.000）。两组在保护人员干预次数（P = 0.203）或参与者对难度的感知方面无显著差异（P = 0.050）。
与传统的路边石攀爬方法相比，高度结构化的方法似乎使身体健全的参与者所需的训练时间减少了不到50%，尽管这一发现仅在统计学上呈趋势。这对临床训练具有启示意义。
