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

Abstract

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. Registration Number NCT03856749.