Improving Clinician Capacity to Provide Interventions for Manual Wheelchair Users

NCT06294834 | Active Not Recruiting

• 2 other identifiers: STUDY2201007190SIMS0010
• Study Type: interventional
• Target: 235
• Locations: 1 country
• Sites: 1

Brief Summary

The objective of this study is to determine the effectiveness of remote manual wheelchair skills training program for clinicians. The study will use three-group approach: intervention with remote feedback (Group 1), control group (Group 2), and structured self-study (Group 3). This demonstrates how the intervention compares not only to a control, but also to the next "best alternative" - therapists sourcing web-based training materials and learning independently.

Conditions

Paraplegia; Paralysis, Legs

Outcome Measures

Primary Outcomes (4)

• Change in Wheelchair Skills Test Questionnaire (WST-Q) score

  Clinician capacity and confidence to complete wheelchair skills, as measured by wheelchair skills test questionnaire (WST-Q), will improve following training (Group 1,3) compared to the active control group (Group 2). The WST-Q includes values from 0-3 for each of Capacity, Confidence, and Performance. These three scores will be averaged. A higher value indicates a better outcome.

  baseline vs. 2 months

• Change in Self-Efficacy on Assessing, Training, and Spotting (SEATS) score

  Clinician confidence to provide wheelchair skills training, as measured by the Self-Efficacy on Assessing, Training, and Spotting (SEATS), will improve following training (Group 1,3) compared to the active control group (Group 2). The SEATS evaluation rates Assessing, Training, and Spotting, on scales from 0-5 for each skill. The values will be combined and averaged to assess progress over time. A higher score indicates improvement.

  baseline vs. 2 months

• Change in number of wheelchair users trained

  Clinician training of wheelchair users will increase in quantity (number of wheelchair users trained, duration of training) in the six months following training (Group 1,3) compared to the active control group (Group 2).

  baseline vs. 6 months

• Change in quality of wheelchair skills trained

  Clinician training of wheelchair users will increase in quality (number of wheelchair skills trained, capacity of trainees) in the year following training (Group 1,3) compared to the active control group (Group 2).

  baseline vs. 6 months

Secondary Outcomes (4)

• Change in rehab professional Wheelchair Skills Test Questionnaire (WST-Q) score

  baseline vs. 2 months, 6 months, and 1 year (Group 1,3 only) following training

• Change in rehab professional Self-Efficacy on Assessing, Training, and Spotting (SEATS) score

  baseline vs. 2 months, 6 months, and 1 year (Group 1,3 only) following training

• Change in rehab professional quantity of wheelchair users trained

  baseline vs. 6 months, and 1 year (Group 1,3 only) following training

• Change in rehab professional quality of wheelchair training

  baseline vs. 6 months, and 1 year (Group 1,3 only) following training

Study Arms (4)

Group 1: therapists

OTHER

Group 1 will receive the active intervention (intervention A) of remote wheelchair skills training. They will cross-over to receive the control intervention (intervention B) of education on wheelchair provision at 6 months.

Other: Part 1 of intervention A - Wheelchair skills training modules; Other: Part 2 of intervention A - Asynchronous feedback from a remote trainer; Other: Intervention B: Education on wheelchair provision

Group 2

OTHER

Group 2 will complete the control intervention (intervention B) of education on wheelchair provision. They will cross-over to receive the active intervention (intervention A) of remote wheelchair skills training at 6 months.

Other: Part 1 of intervention A - Wheelchair skills training modules; Other: Part 2 of intervention A - Asynchronous feedback from a remote trainer; Other: Intervention B: Education on wheelchair provision

Group 3

OTHER

Groups 3 will mirror Group 1 but for intervention A will only complete Part 1 of the training and then be cued weekly to practice.

Other: Part 1 of intervention A - Wheelchair skills training modules; Other: Intervention B: Education on wheelchair provision

Group 4: rehab professionals, not therapists

OTHER

Group 4 will mirror Group 3 but receive access to both interventions at the same time.

Other: Part 1 of intervention A - Wheelchair skills training modules; Other: Intervention B: Education on wheelchair provision

Interventions

Part 1 of intervention A - Wheelchair skills training modules OTHER

Clinicians will review a suite of training videos in a prescribed order that discuss motor learning principles, safe spotting, and how to complete 15 intermediate and advanced skills: 1. Opening/closing doors 2. getting over a gap 3. getting over a threshold 4. ascending a low curb 5. descending a low curb 6. ascending a high curb 7. descending a high curb 8. performing a stationary wheelie 9. descending a high curb in a wheelie position 10. descending a steep incline in a wheelie position and stopping 11. ascending stairs 12. descending stairs 13. completing a floor-to-chair transfer 14. car transfers 15. folding and unfolding wheelchair

Group 1: therapists; Group 2; Group 3; Group 4: rehab professionals, not therapists

Part 2 of intervention A - Asynchronous feedback from a remote trainer OTHER

Participants will practice of wheelchair skills paired with remote feedback. Participants will be reminded to practice once per week. The participant will practice any number of the 15 skills for a self-selected duration. Following each practice session, the participant will upload video(s) of the skills practiced and a session log, indicating any difficulties they encountered. The remote trainer will then review the video-recordings and reply to the participant with feedback.

Group 1: therapists; Group 2

Intervention B: Education on wheelchair provision OTHER

Participants will be provided with access to web-based wheelchair provision education modules. When the content is viewed will be self-selected by participants. Participants will be asked to complete a feedback survey at the end of the modules. Participants will receive weekly reminders to complete the intervention until a feedback survey completed.

Group 1: therapists; Group 2; Group 3; Group 4: rehab professionals, not therapists

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Practicing rehabilitation professional whose client population includes wheelchair users.
• Willing and able to attempt practicing wheelchair skills
• Access to a spotter(s)
• Access to an Internet-ready device with video capabilities.
• Speaks English

You may not qualify if:

• \) Confident in teaching (Self-Efficacy on Assessing, Training, and Spotting \[SEATS\] item score = 5) and able to complete (WST-Q capacity item score = 2) \>50% of skills targeted by the training intervention.

Sponsors & Collaborators

• University of Pittsburgh: lead
• Dalhousie University: collaborator
• National Institute on Disability, Independent Living, and Rehabilitation Research: collaborator

Study Sites (1)

University of Pittsburgh / Rehab Neural Engineering Labs

Pittsburgh, Pennsylvania, 15219, United States

Location

MeSH Terms

Conditions

Paraplegia

Condition Hierarchy (Ancestors)

Paralysis; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Lynn Worobey, PhD/DPT

  University of Pittsburgh

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: For therapists, we will use a randomized, single-blinded, two-period cross-over study design for Groups 1 and 2. Participants will complete baseline assessments and then be randomized to either Group 1 or Group 2. After we have completed enrollment for Groups 1 and 2 we will enroll participants into Group 3. Rehabilitation professionals who are not therapists will be enrolled in Group 4.
• Purpose: OTHER
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Model Details: Randomized, single-blinded, two-period cross-over study design for Groups 1 and 2. Participants will complete baseline assessments and then be randomized to either Group 1 or Group 2. After enrollment for Groups 1 and 2 is complete, participants will be enrolled into Group 3.

Study Record Dates

• First Submitted: February 27, 2024
• First Posted: March 6, 2024
• Study Start: February 22, 2023
• Primary Completion (Estimated): August 30, 2026
• Study Completion (Estimated): December 30, 2026
• Last Updated: October 14, 2025

Record last verified: 2025-10

Locations

US (1)