EVIDENCE

In this section, we provide a brief summary of the published studies to date that support the use of the Wheelchair Skills Program. The measurement properties of the Wheelchair Skills Test (WST) have been documented. 1,2 In these studies, the WST was found to be safe, practical, reliable, valid and useful. The WST has been used as a screening or outcome measure in a number of studies. Further study is needed to evaluate the measurement properties of the WST as it evolves, and in different settings. The relationships between the objective WST and the questionnaire version of the WST (WST-Q) have also been reported. 3,4 The correlations between the total WST and WST-Q scores were found to be excellent, although the WST-Q scores were slightly higher. Regarding the Wheelchair Skills Training Program (WSTP), we have completed two randomized controlled trials on wheelchair users, one on wheelchair users admitted for initial rehabilitation 5 and one on wheelchair users in the community. 6 In both, we found that the WSTP was safe, practical and resulted in significantly greater improvements (2-3 fold) in wheelchair skills performance than standard care. In a third randomized controlled trial, on occupational therapy students, we found that the WSTP resulted in significantly greater improvement (2-3 fold) in wheelchair skills than a standard undergraduate occupational therapy curriculum 7 and that these skills were retained 9-12 months later. 8 Finally, in a recent pilot study in a rehabilitation centre , 9 we provided less than 50 minutes of training on wheelchair-handling skills to caregivers of wheelchair users. We found that the WSTP was an effective way to improve caregiver skills and that these skills were retained. Studies of the safety and effectiveness of the WSTP in other settings are planned.   References 1. Kirby RL, Swuste J, Dupuis DJ, MacLeod DA, Monroe R. Wheelchair Skills Test: pilot study of a new outcome measure. Arch Phys Med Rehabil 2002;83:10-18. 2. Kirby RL, Dupuis DJ, MacPhee AH, Coolen AL, Smith C, Best KL, Newton AM, Mountain AD, MacLeod DA, Bonaparte JP. The Wheelchair Skills Test (version 2.4): measurement properties. Arch Phys Med Rehabil 2004;85:794-804 . 3. Newton AM, Kirby RL, MacPhee AH, Dupuis DJ, MacLeod DA. Evaluation of manual wheelchair skills: is objective testing necessary or would subjective estimates suffice? Arch Phys Med Rehabil 2002;83:1295-9. 4. Mountain AD, Kirby RL, Smith C. The Wheelchair Skills Test: validity of an algorithm-based questionnaire version. Arch Phys Med Rehabil 2004;85:416-23. 5. MacPhee AH, Kirby RL, Coolen AL, Smith C, MacLeod DA, Dupuis DJ. Wheelchair skills training program: a randomized clinical trial on wheelchair users undergoing initial rehabilitation. Arch Phys Med Rehabil 2004;85:41-50. 6. Best KL, Kirby RL, Smith C, MacLeod DA. Wheelchair skills training for community-based manual wheelchair users: a randomized controlled trial. Arch Phys Med Rehabil (in press). 7. Coolen AL., Kirby RL, Landry J, MacPhee AH, Dupuis D, Smith C, Best, KL, MacKenzie DE, MacLeod DA. Wheelchair skills training program for clinicians: a randomized controlled trial with occupational therapy students. Arch Phys Med Rehabil 2004;85:1160-7. 8. Smith C, Best KL, Kirby RL, Coolen AL, MacKenzie DF. Wheelchair skills training program for occupational therapy students: retention and reinforcement one year later. Proceedings of the RESNA 26 th International Conference, Atlanta GA, June 22, 2003. 9. Kirby RL, Mifflen NJ, Thibault DL, Smith C, Best KL, Thompson KJ, MacLeod DA. The wheelchair-handling skills of caregivers and the effect of training. Arch Phys Med Rehabil 2004 85:2011-9.