The Effect of Motor Learning-based Wheelchair Propulsion Training on Wheeling Biomechanics and Gross Mechanical Efficiency in Older Adults: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 35
- 试验地点
- 2
- 主要终点
- Cadence (biomechanical variable)
研究概览
简要总结
Many older adults lack the skill of efficient wheelchair propulsion despite being the largest cohort of wheelchair users. Inefficient wheelchair propulsion can lead to fatigue and overuse injuries that can result in lost independent mobility. This study will evaluate the effectiveness of a new training strategy using a motor learning based approach to train efficient wheelchair propulsion. Participants will be randomly assigned to one of three groups: 1) No practice; 2) Motor learning-based training; or 3) Practice (time-matched to training). Potential improvements based on training will be explored for wheeling biomechanical variables and energy efficiency.
Study Hypothesis: We expect that the Training intervention will be superior to the Practice intervention for improving the biomechanical and physiological efficiency of wheelchair propulsion. It is also hypothesized that both the Training and Practice interventions will be superior to no practice.
详细描述
Sample Size:
Calculations resulted in a sample size of 10 participants for each of the three groups to detect a significant difference with 80% power at a significance level of 0.05 (G*Power 3.1). To account for missing data and loss to follow-up, the sample size was increased by 15% such that each of the three groups will consist of 12 participants for a total of 36 participants.
Participant honorariums:
- All participants will receive $15 for each of the three testing sessions
- Participants randomized to either of the intervention groups (practice or training) will receive $5/ visit (excluding the testing session) to partly compensate for their travel cost.
Assessment for Eligibility:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Able-bodied adults 50+ years of age
- •Reside in the community
- •Have no previous experience using a manual wheelchair
- •Have the physical endurance to walk at a moderate intensity for 10 min
- •Physical activity readiness questionnaire (PAR-Q+) approval for individuals up to 69 y and Physical activity readiness medical examination (PARMED X) approval for individuals over 69 y.
- •Able to read, write and speak English
排除标准
- •Unable to communicate in English
- •Smoke or have respiratory illnesses (i.e. asthma)
- •Have current upper extremity injury or pain
- •Have a mini-mental state examination score of less than 23
- •Have a mass of more than 113kg (upper limit for testing device)
研究组 & 干预措施
Control
The control group will not experience any wheelchair training or 'practice' with a manual wheelchair.
Motor learning-based training
The motor learning-based training, like the 'practice' condition, will consist of six visits over three weeks. Each visit will involve two 5-minute wheeling trials with 10-minutes of rest between trials. The motor learning-based training will focus on variable practice and sporadic feedback.
干预措施: Motor learning-based training (Behavioral)
Practice wheeling
To provide a comparable amount of exposure to wheelchair propulsion, the practice group will participate in the same number of visits and wheeling time as the motor-learning based training group. This will allow us to determine whether the motor-learning based training is superior to exposure through practice. The practice group will come to the lab six times over three weeks and wheel for two 5-minute trials with a 10-minute rest break in between. Participants randomized to this group will receive no feedback.
干预措施: Practice wheeling (Behavioral)
结局指标
主要结局
Cadence (biomechanical variable)
时间窗: Change from baseline at 4 weeks, change from baseline at 6 weeks
Cadence will be collected using a force sensing push rim (SmartWheel).
Force application (biomechanical variable)
时间窗: Change from baseline at 4 weeks, change from baseline at 6 weeks
Force application will be collected using a force sensing push rim (SmartWheel).
Push Angle (biomechanical variable)
时间窗: Change from baseline at 4 weeks, change from baseline at 6 weeks
Push angle will be collected using a force sensing push rim (SmartWheel).
次要结局
- Gross mechanical efficiency(Change from baseline at 4 weeks, change from baseline at 6 weeks)
- Wheelchair skills related to propulsion(Change from baseline at 4 weeks, change from baseline at 6 weeks)
- Wheelchair sprint test (peak power output)(Change from baseline at 4 weeks, change from baseline at 6 weeks)
- Wheeling pattern(Change from baseline at 4 weeks, change from baseline at 6 weeks)
- SmartWheel Clinical Protocol(Change from baseline at 4 weeks, change from baseline at 6 weeks)
研究者
Bonita Sawatzky
Principal Investigator
University of British Columbia