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Completed

NCT Number: NCT06294834

Improving Clinician Capacity to Provide Interventions for Manual Wheelchair Users

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.

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Key information

Conditions

Paraplegia Nervous System Diseases Neurologic Manifestations Paralysis Paralysis, Legs Pathological Conditions, Signs and Symptoms Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Pittsburgh / Rehab Neural Engineering Labs

Pittsburgh, Pennsylvania, 15219, United States

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Practicing rehabilitation professional whose client population includes wheelchair users.
  • Willing and able to attempt practicing wheelchair skills
  • Access to a spotter(s)
  • Access to an Internet-ready device with video capabilities.
  • Speaks English

Exclusion criteria

  • 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.

Treatment and study plan

Part 1 of intervention A - Wheelchair skills training modules

Other

Clinicians will review a suite of training videos in a prescribed order that discuss motor learning principles, safe spotting, and how to complete 15 intermediate and advanced skills:

  • Opening/closing doors
  • getting over a gap
  • getting over a threshold
  • ascending a low curb
  • descending a low curb
  • ascending a high curb
  • descending a high curb
  • performing a stationary wheelie
  • descending a high curb in a wheelie position
  • descending a steep incline in a wheelie position and stopping
  • ascending stairs
  • descending stairs
  • completing a floor-to-chair transfer
  • car transfers
  • folding and unfolding wheelchair

Part 2 of intervention A - Asynchronous feedback from a remote trainer

Other

Participants will practice of wheelchair skills paired with remote feedback. Participants will be reminded to practice once per week. The participant will practice any number of the 15 skills for a self-selected duration. Following each practice session, the participant will upload video(s) of the skills practiced and a session log, indicating any difficulties they encountered. The remote trainer will then review the video-recordings and reply to the participant with feedback.

Intervention B: Education on wheelchair provision

Other

Participants will be provided with access to web-based wheelchair provision education modules. When the content is viewed will be self-selected by participants. Participants will be asked to complete a feedback survey at the end of the modules. Participants will receive weekly reminders to complete the intervention until a feedback survey completed.

Primary outcomes

  1. Change in Wheelchair Skills Test Questionnaire (WST-Q) score

    Time frame: baseline 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.

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

    Time frame: baseline 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.

  3. Change in number of wheelchair users trained

    Time frame: baseline 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).

  4. Change in quality of wheelchair skills trained

    Time frame: baseline 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).

Secondary outcomes

  1. Change in rehab professional Wheelchair Skills Test Questionnaire (WST-Q) score

    Time frame: baseline 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.

  2. Change in rehab professional Self-Efficacy on Assessing, Training, and Spotting (SEATS) score

    Time frame: baseline 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.

  3. Change in rehab professional quantity of wheelchair users trained

    Time frame: baseline 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.

  4. Change in rehab professional quality of wheelchair training

    Time frame: baseline 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.

Sponsors and collaborators

Lead sponsor

University of Pittsburgh

Other

Collaborators

  • Dalhousie University
  • National Institute on Disability, Independent Living, and Rehabilitation Research

Registry information

Acronym: SKILL

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
Mar 6, 2024
Registry last updated
May 19, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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