Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale du Québec, Quebec City, Canada.
Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale du Québec, Quebec City, Canada; Department of Rehabilitation, Université Laval, Quebec City, Canada.
Arch Phys Med Rehabil. 2023 Sep;104(9):1371-1377. doi: 10.1016/j.apmr.2023.04.022. Epub 2023 May 19.
To evaluate the effectiveness of a home-based simulator training, in comparison with a videogame-based training, in terms of powered wheelchair driving skills, skills use in a real-world setting, and driving confidence.
Single-blinded randomized controlled trial.
Community.
New powered wheelchair users (N=47) randomly allocated to simulator group (n=24, 2 drop-out) and control group (n=23, 3 drop-out).
The miWe wheelchair simulator (simulator group) or a kart driving videogame (control group) was setted-up at participants' homes (computer + joystick). They were instructed to use it at least 20 minutes every 2 days, during a period of 2 weeks.
PRIMARY OUTCOME MEASURE(S): Assessments were done at baseline (T1) and post-training (T2) using the Wheelchair Skills Test Questionnaire (WST-Q, version 4.1), Wheelchair Confidence Scale (WheelCon), Assistive Technology Outcomes Profile for Mobility, and Life-Space Assessment (LSA). The time necessary to complete 6 WST tasks was measured with a stopwatch.
Participants of the simulator group significantly increased their WST-Q capacity score at T2 by 7.5% (P<.05), whereas the control group remained at the same score (P=.218). Participants of both groups rolled backward and went through a door significantly faster at T2 (P=.007; P=.016), but their speed did not change for the other skills. The WheelCon score significantly increased after training (+4% for the control group and +3.5% for the simulator group, P=.001). There was no T1-T2 difference between groups for the WST-Q performance scores (P=.119), the ATOP-Activity (P=.686), the ATOP-Participation scores (P=.814), and the LSA score (P=.335). No adverse events or side effects were reported during data collection or training.
Participants of both groups improved some skills and their wheelchair driving confidence. The simulator training group also demonstrated a modest post-training gain in their WST-Q capacity, but more studies would be needed to explore the long-term effects of the McGill immersive wheelchair simulator (miWe) simulator on driving skills.
评估基于家庭的模拟器训练与基于视频游戏的训练在电动轮椅驾驶技能、现实世界环境中的技能使用和驾驶信心方面的有效性。
单盲随机对照试验。
社区。
新的电动轮椅使用者（N=47）随机分配到模拟器组（n=24，2 人退出）和对照组（n=23，3 人退出）。
在参与者家中（计算机+操纵杆）设置 miWe 轮椅模拟器（模拟器组）或赛车驾驶视频游戏（对照组）。他们被指示在两周的时间内，每两天至少使用 20 分钟。
使用轮椅技能测试问卷（WST-Q，第 4.1 版）、轮椅信心量表（WheelCon）、辅助技术移动能力概况和生活空间评估（LSA）在基线（T1）和培训后（T2）进行评估。使用秒表测量完成 6 个 WST 任务所需的时间。
模拟器组参与者的 WST-Q 能力评分在 T2 时显著增加了 7.5%（P<.05），而对照组的评分保持不变（P=.218）。两组参与者向后滚动和通过门的速度在 T2 时显著加快（P=.007；P=.016），但其他技能的速度没有变化。培训后 WheelCon 评分显著增加（对照组增加 4%，模拟器组增加 3.5%，P=.001）。两组之间的 WST-Q 表现评分（P=.119）、ATOP-Activity（P=.686）、ATOP-Participation 评分（P=.814）和 LSA 评分（P=.335）在 T1-T2 之间没有差异。在数据收集或培训期间，没有报告不良事件或副作用。
两组参与者都提高了一些技能和他们的轮椅驾驶信心。模拟器训练组在 WST-Q 能力方面也表现出适度的培训后增益，但需要更多研究来探索麦吉尔沉浸式轮椅模拟器（miWe）模拟器对驾驶技能的长期影响。
