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This study assessed the effectiveness of a learning module we developed for planning students aimed to enhance their understanding for design issues in public spaces faced by wheelchair users. The module involves training of students to effectively navigate the environment in a wheelchair before they experience the real outdoor spaces. Through this evaluation study, we also attempted to add clarity to the problems observed from empirical studies about these 'try-it-yourself' exercises, such as potential stigmatisation and ableism. We employed a mixed-method study approach consisting of wheelchair skill tests, 'walkabout' audits, and a focus group, with 28 second-year undergraduate urban planning students. The cross-over design of the study involving two components of the module -- (wheelchair) Skill Learning Experience (SLE) and Real-World Experience (RWE) -- allowed us to assess the effect of the former on the performance of the latter and the module overall. The focus group also asked students' perspectives about the module. Our findings suggest that the wheelchair skills training component likely contributed to a more nuanced and comprehensive understanding of design problems, while also fostering respect for wheelchair users. We believe that careful implementation is key to addressing potential negative consequences while optimising the benefit of experiential exercises.

To test the hypothesis that a Remote-Learning Course improves the subjective wheelchair-skills performance and confidence of wheelchair service providers, and to determine the participants' views on the Course. This was an observational cohort study, with pre-post comparisons. To meet the objectives of the six-week Course, the curriculum included self-study and weekly one-hour remote meetings. Participants submitted their Wheelchair Skills Test Questionnaire (WST-Q) (Version 5.3.1) "performance" and "confidence" scores before and after the Course. Participants also completed a Course Evaluation Form after the Course. The 121 participants were almost all from the rehabilitation professions, with a median of 6 years of experience. The mean (SD) WST-Q performance scores rose from 53.4% (17.8) pre-Course to 69.2% (13.8) post-Course, a 29.6% relative improvement (p < 0.0001). The mean (SD) WST-Q confidence scores rose from 53.5% (17.9) to 69.5% (14.3), a 29.9% relative improvement (p < 0.0001). Correlations between performance and confidence were highly significant (p < 0.0001). The Course Evaluation indicated that most participants found the Course useful, relevant, understandable, enjoyable, "just right" in duration, and most stated that they would recommend the Course to others. Although there is room for improvement, a Remote-Learning Course improves the subjective wheelchair-skills performance and confidence scores of wheelchair service providers by almost 30%, and participants were generally positive about the Course. A Remote-Learning Course improves the subjective wheelchair-skills performance and confidence scores of wheelchair service providers by almost 30%. Participants were generally positive about the Course. [ABSTRACT FROM AUTHOR]

To test the hypotheses that, in comparison with pushing an occupied upright manual wheelchair forward, pulling backward on the push-handles improves the objective and subjective ease with which a caregiver can get the wheelchair across a soft surface (e.g., grass, mud, sand, gravel); and the ease with which a caregiver can get the wheelchair across a soft surface improves if the wheelchair is tipped back into the wheelie position. We used a randomized crossover trial with within-participant comparisons to study 32 able-bodied pairs of simulated caregivers and wheelchair occupants. The caregiving participants moved an occupied manual wheelchair 5 m across a soft surface (7.5-cm-thick gym mats) under four conditions (upright-forward, upright-backward, wheelie-forward and wheelie-backward) in random order. The main outcome measure was time (to the nearest 0.1 s) and the main secondary measure was the ease of performance (5-point Likert scale). The upright-backward condition was the fastest (p < 0.05) and had the highest ease-of-performance scores. In the forward direction, there was no statistically significant difference in the time required between the upright and wheelie positions, but the wheelie position was considered easier. Although further study is needed, our findings suggest that caregivers should pull rather than push occupied wheelchairs across soft surfaces. In the forward direction, caregivers may find the wheelie position easier than the upright condition. These techniques have the potential to both improve the effectiveness of and reduce injuries to caregivers. Clinical Trial Registration Number: NCT 04998539 Caregivers should pull rather than push occupied manual wheelchairs across soft surfaces. In the forward direction, caregivers may find the wheelie position easier than and preferable to the upright condition. These techniques have the potential to both improve the effectiveness of and reduce injuries to caregivers. [ABSTRACT FROM AUTHOR]

To determine the extent to which wheelchair service providers conduct wheelchair-skills training, the nature of training, and the providers' perceptions on training. Anonymous global online survey consisting of 29 questions administered via the REDCap electronic data-capture tool to English-speaking wheelchair service providers. We received 309 responses from wheelchair service providers in 35 countries. Of the respondents who responded to the question "...do you typically provide wheelchair-skills training...?" 227 (81.6%) reported "yes, always" or "yes, usually" for clients and 213 (81.9%) for caregivers. The median duration of training sessions for clients and caregivers was 45 and 30 min; the median number of sessions was 2 for both. Regarding the importance of training, 251 (94.4%) answered "very important" for clients and 201 (78.5%) for caregivers. For clients and caregivers, 182 (68.4%) and 191 (74.3%) of respondents considered themselves adequately prepared for the trainer role. A variety of barriers and facilitators to training were identified. Most wheelchair service providers report that they provide wheelchair-skills training for clients and their caregivers, most consider such training to be important and most consider themselves adequately prepared for the training role. However, the amount of training is generally minimal. Further efforts are needed to address the identified barriers to training. Most wheelchair-service providers report that they provide wheelchair-skills training. Most consider such training to be important. Most consider themselves adequately prepared. However, the extent of training is generally minimal. These findings have implications for clinicians, educators, and policymakers. [ABSTRACT FROM AUTHOR]

This study assessed the effectiveness of a learning module we developed for planning students aimed to enhance their understanding for design issues in public spaces faced by wheelchair users. The module involves training of students to effectively navigate the environment in a wheelchair before they experience the real outdoor spaces. Through this evaluation study, we also attempted to add clarity to the problems observed from empirical studies about these 'try-it-yourself' exercises, such as potential stigmatisation and ableism. We employed a mixed-method study approach consisting of wheelchair skill tests, 'walkabout' audits, and a focus group, with 28 second-year undergraduate urban planning students. The cross-over design of the study involving two components of the module – (wheelchair) Skill Learning Experience (SLE) and Real-World Experience (RWE) – allowed us to assess the effect of the former on the performance of the latter and the module overall. The focus group also asked students' perspectives about the module. Our findings suggest that the wheelchair skills training component likely contributed to a more nuanced and comprehensive understanding of design problems, while also fostering respect for wheelchair users. We believe that careful implementation is key to addressing potential negative consequences while optimising the benefit of experiential exercises. [ABSTRACT FROM AUTHOR]

To explore the experiences of new motorised mobility scooter users from the perspectives of the assessment and training of scooter skills. Descriptive secondary analysis of qualitative data. Community. 20 New users of motorised mobility scooters. Not applicable. Directed qualitative analysis of up to four semi-structured interviews over the course of the first year of scooter use, to identify themes and sub-themes that could inform recommendations regarding assessment and training protocols. We identified two themes. The first related to potential new content. As one example of the sub-themes, there were many excerpts that dealt with the use of skills in various combinations and permutations that were used to carry out activities during everyday life and participate in society. These excerpts suggested the importance of training skills in combination to facilitate skill transfer (or generalizability). The second theme is related to enhancements of existing content. As one example of the sub-themes, there were several excerpts that dealt with scooter security. These excerpts led to the recommendation that removing and inserting the scooter key should be added to the assessment criteria for the "turns power on and off" skill of the Wheelchair Skills Test (WST) and its questionnaire version (WST-Q). The experiences of scooter users over the first year of receiving a scooter appear to be relevant to the assessment and training of scooter skills and suggest themes for further study. Clinical trial registration number: NCT02696213 The experiences of new scooter users are highly relevant to the assessment and training of scooter skills. These experiences suggest both potential new content and enhancements of existing content to the Wheelchair Skills Program Manual. [ABSTRACT FROM AUTHOR]

The aim of this study was to test the hypotheses that, during manual-wheelchair foot propulsion backward on a soft surface, lowering the seat height increases speed, push frequency and push effectiveness, and decreases perceived difficulty. In a repeated-measures crossover study, 50 able-bodied participants used one foot to propel a manual wheelchair 5 m backward on a soft surface at 5 seat heights, ranging from 5.08 cm below to about 5.08 cm above lower-leg length, in random order. We recorded Wheelchair Skills Test (WST) capacity scores and used the Wheelchair Propulsion Test (WPT) to calculate speed (m/s), push frequency (cycles/s) and push effectiveness (m/cycle). We also recorded the participants' perceived difficulty (0–4) and video-recorded each trial. WST capacity scores were reduced at the higher seat heights. Using repeated-measures models (adjusted for age, sex and order), there were negative relationships between seat height and speed (p < 0.0001) and push effectiveness (p < 0.0001). Lowering the seat height by 5.08 cm below lower-leg length corresponded to improvements in speed of 0.097 m/s and in push effectiveness of 0.101 m/cycle. The trend for push frequency was also significant (p = 0.035) but the effect size was smaller. Perceived difficulty increased with seat height (p < 0.0001). The video-recordings provided qualitative kinematic data regarding the seated "gait cycles". During manual-wheelchair foot propulsion backward on a soft surface, lowering the seat height increases speed and push effectiveness, and decreases perceived difficulty. Backward wheelchair foot propulsion on soft surfaces is affected by seat height. Speed (m/s) is improved if the seat height is lowered. Push effectiveness (m/gait cycle) is improved if the seat height is lowered. Perceived difficulty of propulsion is lower if the seat height is lowered. [ABSTRACT FROM AUTHOR]

To test the hypotheses that, during manual wheelchair foot propulsion forward on smooth level surfaces, lowering the seat height increases speed, push frequency and push effectiveness, and decreases perceived difficulty. In a repeated-measures crossover study, 50 able-bodied participants used one foot to propel a manual wheelchair 10 m on a smooth level surface at 5 seat heights in random order, ranging from 5.08 cm below to about 5.08 cm above lower-leg length. We recorded Wheelchair Skills Test (WST) capacity scores and used the Wheelchair Propulsion Test (WPT) to calculate speed (m/s), push frequency (cycles/s) and push effectiveness (m/cycle). We also recorded the participants' perceived difficulty (0–4) and video-recorded each trial. WST capacity scores were reduced at the higher seat heights. Using repeated-measures models (adjusted for age, sex and order), there were negative relationships between seat height and speed (p < 0.0001) and push effectiveness (p < 0.0001). Lowering the seat height by 5.08 cm below lower-leg length corresponded to improvements in speed of 0.20 m/s and in push effectiveness of 0.20 m/cycle. The trend for push frequency was also significant (p = 0.003) but the effect size was smaller. Perceived difficulty increased with seat height (p < 0.001). The video-recordings provided qualitative kinematic data regarding the seated "gait cycles". During manual wheelchair foot propulsion forward on smooth level surfaces, lowering the seat height increases speed and push effectiveness, and decreases perceived difficulty. NCT03330912. Generally, wheelchairs used for forward foot propulsion should have a seat height that is 2.54-5.08 cm less than the sitting lower-leg length. Clinicians should, however, take into consideration other functions that may be adversely affected by lowering the seat height. [ABSTRACT FROM AUTHOR]

The annual PATH Intl. conference was held in Cleveland, Ohio, November 4-7. As an organization we were able to obtain a grant continuing education hours and networking opportunities to PATH [...]

Purpose: The tilt-rest skill consists of tipping the wheelchair back and allowing it to rest against a solid object with the wheel locks applied (e.g., for pressure redistribution, neck comfort or hands-free activities). The objective of this study was to determine the proportion of experienced manual wheelchair users who are aware of this skill and who can perform it. Materials and methods: We conducted a cross-sectional survey of 49 manual wheelchair users using a questionnaire developed for the purpose. The tilt-rest skill was attempted by those who reported that they were capable of performing it. Results: Participants' mean (SD) age was 55.1 (18.2) years, 38 (77.6%) were male, their median (IQR) duration of wheelchair use was 2 (7.2) years and their mean (SD) daily time spent in the wheelchair was 9.5 (4.6) hours. Twenty-seven (55.1%) participants were aware of the skill, 19 (38.8%) reported being able to perform the skill and 16 of 47 (34.0%) were able to demonstrate the skill. Multivariate modelling with the question "Can you complete the tilt-rest skill?" as the dependent measure revealed an inverse relationship with age – Odds Ratio (95% Confidence Interval) of 0.476 (0.293, 0.774) (p =.0028) for each 10 year increase in age. Conclusions: Only just over half of manual wheelchair users are aware of the tilt-rest skill and one-third of users can perform it. Older people are less likely to report being able to complete the skill. These findings have implications for wheelchair skills training during the wheelchair-provision process. Only just over half of manual wheelchair users are aware of the tilt-rest skill and only about one-third of users can perform it. Older people are less likely to report being able to complete the skill. These findings have clinical implications for wheelchair skills training during the, specifically that clinicians responsible for manual wheelchair-provision process should ensure that appropriate wheelchair users have the opportunity to learn this skill. [ABSTRACT FROM AUTHOR]

If you've been doing equine-assisted activities and therapies for any length of time, you know the tremendous benefits one can achieve from working with horses. Groundwork can provide mental health [...]

PATH Intl. was founded in 1969 to promote safe and effective therapeutic horseback riding throughout the United States and Canada. Today, PATH Intl. has more than 7,500 individual members in [...]

Try an experiment. Go into a room and turn on the television, a radio, flashing lights, and have two or three people talk to you at the same time. Your [...]

When we think of therapeutic horsemanship, we often think of therapeutic horseback riding. That's not surprising, given the many physical benefits of riding including improved balance, flexibility, coordination, core and [...]