Kenyon Lisa K, Hesse Elizabeth N, Pakkala Katelynn J, Vanderest Sebastian
Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA.
Disabil Rehabil Assist Technol. 2021 May 28:1-5. doi: 10.1080/17483107.2021.1931966.
The purpose of this exploratory case series was to describe the outcomes for both a child-learner and a child-peer after a single manual wheelchair (MWC) skills training session involving child-based peer training techniques, followed by related home-based skills practice.
Participants were a 9-year-old with L4-L5 spina bifida (pseudonym: Amari) and a 3-year-old with T10 spina bifida (pseudonym: Mary). Pre-intervention examination included administration of the Wheelchair Skills Test Questionnaire (WST-Q), the MWC short scale within the Mobility domain of the Paediatric Evaluation of Disability - Computer Adapted Test (MWC PEDI-CAT), and the Canadian Occupational Performance Measure (COPM). The peer training session, facilitated by a physical therapy team, involved games and activities involving MWC use. When appropriate, Amari was asked to talk aloud and verbally describe the components of the skills she was performing. Each child and her mother were instructed in specific MWC skills to practice at home over a 3-week period.
Both participants' post-intervention WST-Q capacity, confidence, and performance scores increased. Increases in parent-proxy COPM scores indicated clinically meaningful change in all identified occupational performance problems. Mary's total MWC PEDI-CAT post-intervention score increased by 11 points. Both mothers reported that the participation in the activities helped also to improve their child's self-esteem and self-image.
Both the participants in this exploratory case appeared to demonstrate improvements in MWC skills, self-esteem, and self-image following a single child-based MWC skills peer training session and related home-based skills practice. Future research involving such peer training methods is warranted.
本探索性病例系列的目的是描述在一次涉及基于儿童的同伴训练技术的手动轮椅（MWC）技能训练课程后，儿童学习者和儿童同伴的结果，随后进行相关的家庭技能练习。
参与者是一名患有L4 - L5脊柱裂的9岁儿童（化名：阿马里）和一名患有T10脊柱裂的3岁儿童（化名：玛丽）。干预前检查包括轮椅技能测试问卷（WST - Q）、残疾儿童计算机自适应测试（PEDI - CAT）运动领域内的MWC短量表以及加拿大职业表现测量（COPM）的施测。由物理治疗团队协助进行的同伴训练课程包括涉及MWC使用的游戏和活动。在适当的时候，要求阿马里大声说出并口头描述她正在执行的技能的组成部分。每个孩子及其母亲都被指导了特定的MWC技能，以便在3周内在家中练习。
两名参与者干预后的WST - Q能力、信心和表现得分均有所提高。家长代理的COPM得分增加表明所有已确定的职业表现问题都有临床意义的变化。玛丽干预后的MWC PEDI - CAT总得分提高了11分。两位母亲都报告说，参与这些活动也有助于提高孩子的自尊和自我形象。
在这次探索性病例中，两名参与者在一次基于儿童的MWC技能同伴训练课程及相关家庭技能练习后，MWC技能、自尊和自我形象似乎都有所改善。有必要开展涉及此类同伴训练方法的未来研究。
