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波兰脊髓损伤人群在同伴主导的积极康复营中进行轮椅技能训练的效果:一项队列研究。

Effects of wheelchair skills training during peer-led Active Rehabilitation Camps for people with spinal cord injury in Poland: a cohort study.

机构信息

Department of Adapted Physical Activity, Faculty of Sport Sciences, Poznan University of Physical Education, Poznan, Poland.

Department of Health Sciences Research Group Rehabilitation Medicine, Lund University, and Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.

出版信息

Spinal Cord. 2024 Nov;62(11):651-657. doi: 10.1038/s41393-024-01034-0. Epub 2024 Sep 11.

Abstract

STUDY DESIGN

Prospective cohort study.

OBJECTIVES

To evaluate the effects of wheelchair skills training (WSTR) for participants with spinal cord injury (SCI) during peer-led Active Rehabilitation Camps (ARC) in Poland. We hypothesized that participation in ARC will improve wheelchair skill performance and self-efficacy in individuals with SCI. We also aimed to determine demographic and injury-related factors associated with greater improvements in wheelchair skill performance and self-efficacy.

SETTING

Thirteen consecutive ARCs in Poland.

METHODS

Participants (n = 122) with traumatic or nontraumatic SCI older than 16 years were evaluated at the beginning (T1) and completion (T2) of ARC and at 3-month follow-up (T3) through the Queensland Evaluation of Wheelchair Skills (QEWS) and the Wheelchair Skills Test Questionnaire (WST-Q).

RESULTS

At T2, 43% of participants reached the threshold for substantial clinically meaningful change in QEWS, 73% in WST-Q capacity, and 67% in confidence, with approximately half of those reporting such gains at T3. At a group level, participants achieved small effect-size improvements (QEWS) at T2; large effects in wheelchair skills capacity at T2 and T3; large effects in wheelchair skill confidence at T2, and low effects at T3. Prior attendance to ARC was the only independent variable that explained 10% of variance in wheelchair capacity gains.

CONCLUSIONS

Peer-led WSTR during ARCs is highly effective at improving wheelchair skills in individuals with SCI. These improvements are largely retained after three months. Persons with SCI should have a chance to participate in more than one camp to maintain and further improve their wheelchair skills.

摘要

研究设计

前瞻性队列研究。

目的

评估在波兰由同伴主导的主动康复营(ARC)中进行轮椅技能训练(WSTR)对脊髓损伤(SCI)参与者的影响。我们假设,参加 ARC 将提高 SCI 个体的轮椅技能表现和自我效能感。我们还旨在确定与轮椅技能表现和自我效能感的更大改善相关的人口统计学和损伤相关因素。

设置

波兰的 13 个连续 ARC。

方法

在 ARC 的开始(T1)和结束(T2)以及 3 个月随访(T3)时,评估了年龄大于 16 岁的创伤性或非创伤性 SCI 参与者,通过昆士兰轮椅技能评估(QEWS)和轮椅技能测试问卷(WST-Q)进行评估。

结果

在 T2 时,43%的参与者达到了 QEWS 中实质性临床有意义变化的阈值,73%在 WST-Q 能力方面,67%在信心方面,大约有一半的参与者在 T3 时报告了这些改善。在群体水平上,参与者在 T2 时取得了小的效应量改善(QEWS);在 T2 和 T3 时,轮椅技能能力方面取得了大的效果;在 T2 时,轮椅技能信心方面取得了大的效果,而在 T3 时则取得了小的效果。以前参加 ARC 是唯一能够解释轮椅能力提高 10%差异的独立变量。

结论

在 ARC 中由同伴主导的 WSTR 非常有效地提高了 SCI 个体的轮椅技能。这些改善在三个月后仍基本保持。SCI 患者应该有机会参加多个营地,以维持和进一步提高他们的轮椅技能。

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