1 Department of Physical Education, Hangzhou Normal University Qianjiang College, Hangzhou, China.
2 School of Kinesiology, Shanghai University of Sport, Shanghai, China.
Clin Rehabil. 2017 Dec;31(12):1573-1582. doi: 10.1177/0269215517712043. Epub 2017 Jun 5.
To comprehensively assess the effectiveness and safety of wheelchair skills training program in improving wheelchair skills capacity.
PubMed, OVID, EBSCO, ScienceDirect, Web of Science, CINAHL, Cochrane Library, Google Scholar, and China Knowledge Resource Integrated Database were searched up to March 2017.
Controlled clinical trials that compared a wheelchair skills training program with a control group that received other interventions and used the wheelchair skills test scores to evaluate wheelchair skills capacity were included. Two authors independently screened articles, extracted data, and assessed the methodological quality using the Cochrane risk-of-bias tool in randomized controlled trial (RCT) and methodological index for non-randomized studies. The data results of wheelchair skills test scores were extracted.
Data from 455 individuals in 10 RCTs and from 140 participants in seven non-randomized studies were included for meta-analysis using Stata version 12.0 (Stata Corporation, College Station, TX, USA). In the short term (immediately to one week) post-intervention, relative to a control group, manual wheelchair skills training could increase the total wheelchair skills test scores by 13.26% in RCTs (95% confidence interval (CI), 6.19%-20.34%; P < 0.001) and by 23.44% in non-randomized studies (95% CI, 13.98%-32.90%; P < 0.001). Few adverse events occurred during training; however, compared with a control group, evidence was insufficient to support the effectiveness of powered wheelchair skills training and the long-term (3-12 months) advantage of manual wheelchair skills training ( P = 0.755).
The limited evidence suggests that wheelchair skills training program is beneficial in the short term, but its long-term effects remain unclear.
全面评估轮椅技能训练计划在提高轮椅技能能力方面的有效性和安全性。
检索了 PubMed、OVID、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、Google Scholar 和中国知识资源总库，截至 2017 年 3 月。
纳入了比较轮椅技能训练计划与接受其他干预措施并使用轮椅技能测试评分评估轮椅技能能力的对照组的对照临床试验。两名作者独立筛选文章、提取数据，并使用随机对照试验（RCT）和非随机研究方法学指数的 Cochrane 偏倚风险工具评估方法学质量。提取轮椅技能测试评分的结果数据。
使用 Stata 版本 12.0（Stata 公司，德克萨斯州学院站）对 10 项 RCT 中 455 人和 7 项非随机研究中 140 名参与者的数据进行了荟萃分析。在干预后的短期（即刻至一周），与对照组相比，手动轮椅技能训练可使 RCT 中的总轮椅技能测试评分增加 13.26%（95%置信区间[CI]，6.19%-20.34%；P<0.001）和非随机研究中的 23.44%（95%CI，13.98%-32.90%；P<0.001）。训练期间很少发生不良事件；然而，与对照组相比，证据不足以支持动力轮椅技能训练的有效性和手动轮椅技能训练的长期（3-12 个月）优势（P=0.755）。
有限的证据表明，轮椅技能训练计划在短期内是有益的，但长期效果尚不清楚。
