The Effect of a Wheelchair skills training programme for children: A Pilot Study

Abstract DetailsAbstract Title * Wheelchair skills programme for childrenPaper Type Free PaperPresentation Type: PlatformSummary * 50 words maxThis study is framed around promotion of independence linked to wheel chair skills acquisition in young wheelchair users. The project implemented a wheelchair skills programme and tested the participant’s skill’s level pre and post intervention. Results showed an improvement in basic and intermediate skills and in confidence and independence post interventionAims and Objectives * 70 words maxTo explore the efficacy of a wheelchair skills training programme on wheelchair skill’s development and independence of young wheelchair usersBackground, Technique, Standards, Clinical Detail, Results and Testing * 500 words maxBackground: In 2008, the Department of Health and Social Services and Public Safety, Northern Ireland launched the “Proposals for the reform of the Northern Ireland Wheelchair Service” (2008). Recommendations for service improvements were made following a 2-year review completed in partnership with healthcare staff and wheelchair service users. The review highlighted the lack of a strategic regional delivery of manual wheelchair skills training for children. With inequitable provision of wheelchair skills training opportunities for children across the region for example: some trusts offered training via local clubs, while other trusts relied solely on charities to deliver training, all resulted in uncoordinated, unregulated wheelchair skills training for children across Northern Ireland. The importance of this project was to evaluate the efficiency of a skills teaching programme in order to deliver a standardised manual wheelchair skills training programme for children across Northern Ireland.Sample: 11 participants were recruited initially and gave on informed consent. The mean age was 10.5 years. Participants physical disability diagnosis included Cerebral Palsy (5), Spina Bifida (4), Muscular Dystrophy (1), Spondyloepiphyseal Dysplasias Congenita (1). All participants were manual wheelchair users. Outcome measures: Demographic questionnaire; The Activity Scale for Kids. (Young, Williams et al., 2007); an Impact questionnaire .what about how you tested the skills level??? Is that the Activity for kids??Testing: The wheelchair skills programme took place in the Joey Dunlop Centre, Ballymoney over an eight-month period consisting of two testing days (pre/post wheelchair skills training) and six monthly training sessions. The Regional Wheelchair Training OT carried out the wheelchair skills training while the PhD researcher carried out pre and post testing. The skills test used was developed by the Regional Wheelchair Skills training therapist and was adapted for children. The test was split into three levels – basic, intermediate and advanced skills, the children were tested on the basic and intermediate levels only. Data Analysis: All data was collected and input to Excel. For statistical analysis the data was exported to SPSS. Demographic data was analysed using descriptive statistics and the impact questionnaire was analysed using qualitative content analysis. The Wheelchair Skills Test results and the Activity Scale for Kids scores were analysed using inferential statistics (Wilcoxon t-test) to compare pre and post-test scores. How did you assign a value to the answers on the Q??explain this too.Results: Eight participants competed the full intervention (one not tested; one opted out mid pre-test, one was sick for the post-test). All eight participants showed an increase in the basic (9%) and intermediate levels (31%), although not significant – (p=0.041), (p=0.12). The Activity Scale for Kids’ (ASK) questionnaire showed little to no increase in performance post skills training (mean = 1%; std dev. = 12.8). Participants and parents reported enjoying the sessions and created a social outlet for their children to meet other wheelchair users and parents to converse. In addition, participants reported feeling more confident and independent following the training sessions.Ethics: Ethical approval was obtained via application to the University Research Governance Filter Committee, Office of Research Ethics, NI and governance through the Northern Health and Social Care Trust.Discussion *250 words maxThe aim of this study was to test if a wheelchair skills training programme could improve skills acquisition in children who require a manual wheelchair for functional mobility. Of the participants tested, improved skill acquisition was observed in both basic and intermediate skills (9%) and (31%) respectively. Inferential statistics showed this was not statistically significant primarily due to the small sample size (p=0.041), (p=0.12). The Activity Scale for Kids questionnaire was completed both pre and post training and showed little to no improvement in performance overall. This may be due to who completed the questionnaire, for example: in some cases, the parent completed the questionnaire on behalf of the child, and at the posttest, the other parent may have completed the questionnaire. Some of the children completed the questionnaire independently and it is possible that each parent/child would have a different viewpoint as to what the child’s ability may be. The impact questionnaire, although not as stringent as the Activity Scale for Kids questionnaire, showed more positive feedback from parents and children alike. Participants feedback was generally positive with all stating they enjoyed the monthly sessions. Many parents voiced their concerns over the lack of activities available to their children and availed of this research programme as they felt it was specifically tailored to the needs of their child. Parents reported children practiced their skills at home between monthly sessions and felt their child had more confidence in using their wheelchair. Authors and ReferencesPresenting Author * Adrienne McCannAdditional Author Dr Mary Hannon-FletcherAdditional Author Dr Daniel KerrReferencesDHSSPSNI, 2008. Proposals for the reform of the Northern Ireland Wheelchair service. Northern Ireland: DHSSPS.YOUNG, N., WILLIAMS, J., YOSHIDA, K. and WRIGHT, J., 2000. Measurement properties of the Activities Scale for Kids . Journal of Clinical Epidemiology, 53(2), pp. 125-137