A conceptual framework to assess effectiveness in wheelchair provision

Background: Currently, inadequate wheelchair provision has forced many people with disabilities to be trapped in a cycle of poverty and deprivation, limiting their ability to access education, work and social facilities. This issue is in part because of the lack of collaboration among various stakeholders who need to work together to design, manufacture and deliver such assistive mobility devices. This in turn has led to inadequate evidence about intervention effectiveness, disability prevalence and subsequent costeffectiveness that would help facilitate appropriate provision and support for people with disabilities. Objectives: In this paper, we describe a novel conceptual framework that can be tested across the globe to study and evaluate the effectiveness of wheelchair provision. Method: The Comparative Effectiveness Research Subcommittee (CER-SC), consisting of the authors of this article, housed within the Evidence-Based Practice Working Group (EBP-WG) of the International Society of Wheelchair Professionals (ISWP), conducted a scoping review of scientific literature and standard practices used during wheelchair service provision. The literature review was followed by a series of discussion groups. Results: The three iterations of the conceptual framework are described in this manuscript. Conclusion: We believe that adoption of this conceptual framework could have broad applications in wheelchair provision globally to develop evidence-based practices. Such a perspective will help in the comparison of different strategies employed in wheelchair provision and further improve clinical guidelines. Further work is being conducted to test the efficacy of this conceptual framework to evaluate effectiveness of wheelchair service provision in various settings across the globe

Expertise Moderates Incidentally Learned Associations Between Words and Images

Individuals with expertise in a domain of knowledge demonstrate superior learning for information in their area of expertise, relative to non-experts. In this study, we investigated whether expertise benefits extend to learning associations between words and images that are encountered incidentally. Sport-knowledge-experts and non-sports-experts encountered previously unknown faces through a basic perceptual task. The faces were incidentally presented as candidates for a position in a sports team (a focus of knowledge for only the sports-experts) or for a job in a business (a focus of knowledge for both the sports-experts and non-sports-experts). Participants later received a series of surprise memory tests that tested: ability to recognize each face as being old, the amount of information recalled about each face, and ability to select a correct face from equally familiar alternatives. Relative to non-sports-experts, participants with superior sports expertise were able to better recall the information associated with each face and could better select associated faces from similarly familiar options for the hypothetical prospective athletes. Hypothetical job candidates were recalled and selected at similar levels of performance in both groups. The groups were similarly familiar with the images (in a yes/no recognition memory test) when the faces were prospective athletes or job candidates. These findings suggest a specific effect of expertise on associative memory between words and images, but not for individual items, supporting a dissociation in how expertise modulates the human memory system for word–image pairings

A Participatory Approach to Develop the Power Mobility Screening Tool and the Power Mobility Clinical Driving Assessment Tool

The electric powered wheelchair (EPW) is an indispensable assistive device that increases participation among individuals with disabilities. However, due to lack of standardized assessment tools, developing evidence based training protocols for EPW users to improve driving skills has been a challenge. In this study, we adopt the principles of participatory research and employ qualitative methods to develop the Power Mobility Screening Tool (PMST) and Power Mobility Clinical Driving Assessment (PMCDA). Qualitative data from professional experts and expert EPW users who participated in a focus group and a discussion forum were used to establish content validity of the PMCDA and the PMST. These tools collectively could assess a user’s current level of bodily function and their current EPW driving capacity. Further multicenter studies are necessary to evaluate the psychometric properties of these tests and develop EPW driving training protocols based on these assessment tools