Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL.
Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
Arch Phys Med Rehabil. 2014 Jan;95(1):10-19.e11. doi: 10.1016/j.apmr.2013.06.028. Epub 2013 Jul 13.
To determine if strict use of the Paralyzed Veterans of America's Clinical Practice Guidelines for Preservation of Upper Limb Function affects wheelchair setup, selection, propulsion biomechanics, pain, satisfaction with life, and participation of individuals with new spinal cord injuries (SCIs).
Single blinded, randomized controlled trial.
Model SCI systems rehabilitation facility and community.
Volunteer sample of manual wheelchair users with new SCIs (N=37).
The intervention group was strictly educated on the clinical practice guideline by a physical therapist and an occupational therapist in an inpatient rehabilitation facility. The standard of care group received standard therapy services.
Comparison of wheelchair setup, selection, propulsion biomechanics, pain, and Satisfaction With Life Scale and Craig Handicap Assessment and Reporting Technique scores at the time of discharge from inpatient rehabilitation and at 6 months and 1 year postdischarge.
Participants in the intervention group pushed on tile with significantly lower push frequency (P=.02) at the discharge visit. On the ramp, the intervention group used a significantly larger push length (P=.03) across all time points. No significant differences were found between groups related to wheelchair setup, selection, pain, satisfaction with life, and participation.
The intervention group showed better skills on key wheelchair propulsion biomechanics variables related to upper-limb health. Use of a structured education program may be an effective method of educating new manual wheelchair users to prevent the development of upper-limb impairments in an inpatient setting. Additional follow-up testing is necessary to determine whether the differences seen in propulsion skills translate into decreased pain and improved quality of life in the long term.
确定严格遵循美国瘫痪退伍军人协会（Paralyzed Veterans of America）的上肢功能保护临床实践指南对上肢功能的影响，是否会影响轮椅的设置、选择、推动生物力学、疼痛、生活满意度和新脊髓损伤（spinal cord injury，SCI）患者的参与度。
单盲、随机对照试验。
模型 SCI 系统康复设施和社区。
新 SCI 患者（N=37）的自愿轮椅使用者样本。
干预组在住院康复期间，由物理治疗师和职业治疗师对他们进行严格的临床实践指南教育。对照组接受标准的治疗服务。
比较两组在出院时和出院后 6 个月、1 年时的轮椅设置、选择、推动生物力学、疼痛以及生活满意度量表和 Craig 手功能评估及报告技术评分。
干预组在出院时推地的频率显著降低（P=.02）。在上坡时，干预组在所有时间点的推程都明显更大（P=.03）。两组在轮椅设置、选择、疼痛、生活满意度和参与度方面无显著差异。
干预组在与上肢健康相关的关键轮椅推动生物力学变量方面表现出更好的技能。使用结构化教育计划可能是一种有效的方法，可以在住院环境中教育新的手动轮椅使用者，以预防上肢损伤的发生。需要进一步的随访测试，以确定在推动技能方面看到的差异是否会在长期内转化为减轻疼痛和提高生活质量。
