Manual wheelchair tilt-rest skill: a cross-sectional survey of awareness and capacity among wheelchair users

<p><b>Purpose:</b> The tilt-rest skill consists of tipping the wheelchair back and allowing it to rest against a solid object with the wheel locks applied (e.g., for pressure redistribution, neck comfort or hands-free activities). The objective of this study was to determine the proportion of experienced manual wheelchair users who are aware of this skill and who can perform it.</p> <p><b>Materials and methods:</b> We conducted a cross-sectional survey of 49 manual wheelchair users using a questionnaire developed for the purpose. The tilt-rest skill was attempted by those who reported that they were capable of performing it.</p> <p><b>Results:</b> Participants’ mean (SD) age was 55.1 (18.2) years, 38 (77.6%) were male, their median (IQR) duration of wheelchair use was 2 (7.2) years and their mean (SD) daily time spent in the wheelchair was 9.5 (4.6) hours. Twenty-seven (55.1%) participants were aware of the skill, 19 (38.8%) reported being able to perform the skill and 16 of 47 (34.0%) were able to demonstrate the skill. Multivariate modelling with the question “Can you complete the tilt-rest skill?” as the dependent measure revealed an inverse relationship with age – Odds Ratio (95% Confidence Interval) of 0.476 (0.293, 0.774) (<i>p</i> = .0028) for each 10 year increase in age.</p> <p><b>Conclusions:</b> Only just over half of manual wheelchair users are aware of the tilt-rest skill and one-third of users can perform it. Older people are less likely to report being able to complete the skill. These findings have implications for wheelchair skills training during the wheelchair-provision process.Implications for Rehabilitation</p><p>Only just over half of manual wheelchair users are aware of the tilt-rest skill and only about one-third of users can perform it.</p><p>Older people are less likely to report being able to complete the skill.</p><p>These findings have clinical implications for wheelchair skills training during the, specifically that clinicians responsible for manual wheelchair-provision process should ensure that appropriate wheelchair users have the opportunity to learn this skill.</p><p></p> <p>Only just over half of manual wheelchair users are aware of the tilt-rest skill and only about one-third of users can perform it.</p> <p>Older people are less likely to report being able to complete the skill.</p> <p>These findings have clinical implications for wheelchair skills training during the, specifically that clinicians responsible for manual wheelchair-provision process should ensure that appropriate wheelchair users have the opportunity to learn this skill.</p

Wheelchair skills training for caregivers of manual wheelchair users: a randomized controlled trial comparing self-study and remote training

In this single-blind randomized controlled trial, we tested the hypotheses that, in comparison with control participants receiving only self-study materials (SS group), caregivers of manual wheelchair users who additionally receive remote training (RT group) have greater total Wheelchair Skills Test Questionnaire (WST-Q) performance and confidence scores post-training and at follow-up; and that self-study and remote training each individually lead to such gains. We studied 23 dyads of wheelchair users and their caregivers. Caregivers in the SS group received a handbook and videorecording. Those in the RT group also received up to four real-time (“synchronous”) sessions remotely. The WST-Q 5.1 was administered pre-training (T1), post-training (T2), and after a 3-month follow-up (T3). The mean total WST-Q scores of both groups rose slightly at each new assessment. For the T2-T1 and T3-T1 gains, there were no statistically significant differences between the groups for either WST-Q performance or WST-Q confidence. For performance, the T2-T1 gain was statistically significant for the RT group and the T3-T2 gain was statistically significant for the SS group. For both groups, the T3-T1 gains in performance were statistically significant with gains of 12.9% and 18.5% relative to baseline for the SS and RT groups. For confidence, only the T3-T1 gain for the SS group was statistically significant with a gain of 4.5% relative to baseline. Although less than the gains previously reported for in-person training, modest but important gains in total WST-Q performance scores can be achieved by self-study, with or without remote training. NCT03856749. Self-study can improve the manual wheelchair skills of caregivers.Remote training can improve the manual wheelchair skills of caregivers.Improvements are slightly less than those reported in the literature for in-person training. Self-study can improve the manual wheelchair skills of caregivers. Remote training can improve the manual wheelchair skills of caregivers. Improvements are slightly less than those reported in the literature for in-person training.</p