The manual wheelchair-handling skills of caregivers and the effect of training

Objective: To test the hypothesis that the Wheelchair Skills Training Program (WSTP) is effective in improving the wheelchair-handling skills of untrained caregivers. Design: Within-participant comparisons. Setting: Rehabilitation center and community. Participants: Twenty-four caregivers of manual wheelchair users. Interventions: Caregiver participants underwent the WSTP, version 2.4, adapted for caregivers. Training was individualized on the basis of an integrated testing-and-training protocol that took place on a single occasion (total, approximate to50min). Main Outcome Measures: Total percentage scores on the objective Wheelchair Skills Test (WST), version 2.4, for the pretraining (N=24), posttraining (N=24), and retention (n=9) evaluations. For the skill-transfer evaluation (n=10), we used the questionnaire version (WST-Q), administered by telephone to participants after return to their communities. Results: There were no serious adverse incidents. The mean pretraining total WST score +/- standard deviation was 77.8%+/-12.0%. Posttraining, this increased to 94.7%+/-7.1% (P<.001), a 22% relative increase. At retention testing, a median latency of 7 days later, the mean value, 94.2%+/-7.1%, did not decrease significantly from the posttraining level (P=.38). At skill-transfer testing, a median latency of 179 days posttraining, the mean value, 92.5%+/-8.7%, did not decrease significantly from the posttraining level (P=.73). The greatest improvements were at the advanced skill level. Conclusions: The WSTP is a safe, practical, and effective method of improving the wheelchair-handling skills of untrained caregivers. Skill improvements are generally well retained and transfer well to the community. Such training could play an important role in the rehabilitation process.