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Improving Clinician Capacity to Provide Interventions for Manual Wheelchair Users

Not Applicable
Recruiting
Conditions
Paraplegia
Paralysis, Legs
Interventions
Other: Part 1 of intervention A - Wheelchair skills training modules
Other: Part 2 of intervention A - Asynchronous feedback from a remote trainer
Registration Number
NCT06294834
Lead Sponsor
University of Pittsburgh
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.

Detailed Description

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

Group 1 will receive the active intervention (intervention A) which will include a two-part training in wheelchair skills. For Part 1, they will review approximately 4 hours of educational videos on how to complete and teach wheelchair skills. For Part 2 they will complete a practice-feedback loop with a remote trainer providing asynchronous feedback. Group 3 will mirror Group 1 but complete only Part 1 of the training. Group 2 will receive the control intervention (intervention B) participants will review approximately 4 hours of educational videos. Participants will have 8 weeks to complete either training program. Both groups will then complete follow-up at 2 and 6 months. Following this, participants will cross over to receive the other intervention (Group 1 and 3 will receive intervention B, Group 2 will receive intervention A) and complete follow-up at 8 and 12 months.

Additionally, rehabilitation professionals who are not therapists will be able to access the training through a structured self-study (Group 4). This group will receive access to both trainings with follow-up at 2 and 6 months.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
240
Inclusion Criteria
  1. Practicing rehabilitation professional whose client population includes wheelchair users.
  2. Willing and able to attempt practicing wheelchair skills
  3. Access to a spotter(s)
  4. Access to an Internet-ready device with video capabilities.
  5. Speaks English
Exclusion Criteria
  1. 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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Group 1: therapistsPart 1 of intervention A - Wheelchair skills training modulesGroup 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.
Group 4: rehab professionals, not therapistsPart 1 of intervention A - Wheelchair skills training modulesGroup 4 will mirror Group 3 but receive access to both interventions at the same time.
Group 1: therapistsPart 2 of intervention A - Asynchronous feedback from a remote trainerGroup 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.
Group 2Part 1 of intervention A - Wheelchair skills training modulesGroup 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.
Group 2Part 2 of intervention A - Asynchronous feedback from a remote trainerGroup 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.
Group 3Part 1 of intervention A - Wheelchair skills training modulesGroups 3 will mirror Group 1 but for intervention A will only complete Part 1 of the training and then be cued weekly to practice.
Primary Outcome Measures
NameTimeMethod
Change in Wheelchair Skills Test Questionnaire (WST-Q) scorebaseline vs. 2 months

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.

Change in Self-Efficacy on Assessing, Training, and Spotting (SEATS) scorebaseline vs. 2 months

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.

Change in quality of wheelchair skills trainedbaseline vs. 6 months

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).

Change in number of wheelchair users trainedbaseline vs. 6 months

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).

Secondary Outcome Measures
NameTimeMethod
Change in rehab professional quality of wheelchair trainingbaseline vs. 6 months, and 1 year (Group 1,3 only) following training

Rehabilitation professional training of wheelchair users will increase in quality (number of wheelchair skills trained, capacity of trainees) in the year following training.

Change in rehab professional Wheelchair Skills Test Questionnaire (WST-Q) scorebaseline vs. 2 months, 6 months, and 1 year (Group 1,3 only) following training

Rehabilitation professional capacity and confidence to complete wheelchair skills, as measured by wheelchair skills test questionnaire (WST-Q), will improve following training. 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.

Change in rehab professional Self-Efficacy on Assessing, Training, and Spotting (SEATS) scorebaseline vs. 2 months, 6 months, and 1 year (Group 1,3 only) following training

Rehabilitation professional confidence to provide wheelchair skills training, as measured by the Self-Efficacy on Assessing, Training, and Spotting (SEATS), will improve following training. 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.

Change in rehab professional quantity of wheelchair users trainedbaseline vs. 6 months, and 1 year (Group 1,3 only) following training

Rehabilitation professional training of wheelchair users will increase in quantity (number of wheelchair users trained, duration of training) following training.

Trial Locations

Locations (1)

University of Pittsburgh / Rehab Neural Engineering Labs

🇺🇸

Pittsburgh, Pennsylvania, United States

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