Wheelchair Skills Training for Cerebral Palsy

Age: < 18

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Grand Valley State University

Disqualifiers: Cannot sit for 60 minutes, Own power wheelchair, Others

No Placebo Group

Approved in 2 Jurisdictions

Trial Summary

What is the purpose of this trial?

For children with severe cerebral palsy, a powered wheelchair (PWC) may provide their only option for functional mobility and independence. PWC use is often restricted to a small percentage of children who can quickly demonstrate proficient PWC skills within a single 30-minute PWC trial. This 2-arm, parallel group, single blinded, pre-test-post-test randomized controlled trial will test our hypothesis that an 8-week PWC skills training intervention will produce greater improvements in children's PWC skills capacity immediately after the intervention and at an 8-week follow-up assessment.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Power wheelchair skills training using the IndieTrainer system?

Research suggests that powered wheelchair skills training programs, like the IndieTrainer system, can improve wheelchair skills capacity and participation for individuals with mobility limitations, including children with cerebral palsy. ^{1 2 3 4 5}

Is wheelchair skills training safe for people with cerebral palsy?

The available research does not provide specific safety data for the IndieTrainer system or similar powered wheelchair skills training programs, but these interventions are generally designed to improve mobility skills safely. ^{1 2 3 6 7}

How is the IndieTrainer system treatment different from other treatments for cerebral palsy?

The IndieTrainer system is unique because it combines a mobility device with gamified training modules to help children with cerebral palsy learn powered wheelchair skills, making the training more engaging and potentially more effective than traditional methods. ^{1 2 5 8 9}

Research Team

Eligibility Criteria

This trial is for children with severe cerebral palsy who may benefit from using a powered wheelchair (PWC) for mobility and independence. To join, they must be able to participate in an 8-week training program and follow-up assessments.

Inclusion Criteria

I can show cause and effect skills in powered mobility at a Phase 4 level or higher.

I cannot walk or move a wheelchair on my own as confirmed by a health professional.

I have severe cerebral palsy (difficulty moving and keeping balance).

Exclusion Criteria

My wheelchair or stroller is not compatible with the IndieTrainer System.

I already use a power wheelchair prescribed for me.

A health professional has deemed power wheelchair training unsafe for me due to my medical history.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive an 8-week PWC skills training intervention using the IndieTrainer System

8 weeks

Weekly sessions

Follow-up

Participants are monitored for improvements in PWC skills capacity and performance 8 weeks after the intervention

8 weeks

1 visit (in-person)

Treatment Details

Interventions

• Power wheelchair skills training using the IndieTrainer system (Behavioural Intervention)

Trial Overview The study is testing if special training using the IndieTrainer system over 8 weeks can help these kids get better at controlling their power wheelchairs. It's a randomized trial where some will receive this training while others won't, to compare outcomes.

Participant Groups

Group I: Group A: Experimental Group Experimental Treatment 1 Intervention

Group A: The Experimental Group will receive the 8-week evidence-based PWC skills training using the IndieTrainer System following T0 baseline testing

Group II: Group B: Wait List Control Group Active Control 1 Intervention

Group B: The Wait List Control Group will receive the 8-week evidence-based PWC skills training using the IndieTrainer System following T2 testing

Who Is Running the Clinical Trial?

Grand Valley State University

Lead Sponsor

Trials

13

Recruited

8,700+

Findings from Research

The IndieTrainer system, which combines a mobility device with gamified training, aims to improve powered wheelchair skills in children with cerebral palsy, and is being tested in a small-scale study involving 25 child-parent dyads over three weeks.

This innovative system is designed to support early learners who may not yet grasp cause and effect, making it a unique tool for enhancing mobility skills in children with CP.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The IndieTrainer system: a clinical trial protocol exploring use of a powered wheelchair training intervention for children with cerebral palsy. Kenyon, LK., Farris, J., Veety, L., et al.[2023]

A structured short-term training intervention significantly improved transfer skills in pediatric wheelchair users, with the intervention group scoring an average of 9.06 compared to 7.15 in the control group, indicating effective training outcomes.

The improvements in transfer skills observed in children were comparable to those seen in adult wheelchair users, suggesting that similar training methods can be beneficial across age groups, potentially aiding in long-term upper extremity preservation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Short-term influence of transfer training among full time pediatric wheelchair users: A randomized trial. Rice, LA., Dysterheft, JL., Sanders, E., et al.[2018]

A feasibility study is being conducted with 32 older adults with mild to moderate cognitive impairment to evaluate a powered-wheelchair training program that uses errorless learning strategies and shared control technology.

The program aims to improve powered-wheelchair skills, suggesting that this method could effectively address the learning needs of older adults who struggle with traditional training methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility RCT protocol evaluating a powered-wheelchair training program for older adults. Smith, EM., Miller, WC., Mortenson, WB., et al.[2019]

A wheelchair skills training program significantly improves manual wheelchair skills capacity in the short term, with a 13.26% increase in skills test scores compared to control groups in randomized controlled trials and a 23.44% increase in non-randomized studies.

While the training shows short-term benefits, the long-term effectiveness of manual wheelchair skills training and the effectiveness of powered wheelchair skills training remain unclear, with insufficient evidence to support lasting advantages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review. Tu, CJ., Liu, L., Wang, W., et al.[2022]

In a study of 10 children with severe dyskinetic cerebral palsy using power wheelchairs, dystonia was found to be significantly more prevalent and severe (83.6%) compared to choreoathetosis (34.4%), indicating that dystonia has a greater impact on mobility performance.

The study revealed strong correlations between the severity of arm dystonia and mobility performance, suggesting that as children gain more experience with driving the wheelchair, they develop strategies to manage the effects of their movements on performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dystonia and choreoathetosis presence and severity in relation to powered wheelchair mobility performance in children and youth with dyskinetic cerebral palsy. Bekteshi, S., Konings, M., Nica, IG., et al.[2021]

The Hybrid Course developed by the International Society of Wheelchair Professionals significantly improved wheelchair service knowledge among participants, with an average score increase of 10.84 points on the ISWP Wheelchair Service Provision-Basic Test after training.

The course met quality standards as evaluated by external reviewers, demonstrating its effectiveness and potential for better training of wheelchair providers, which is crucial for reducing health risks in wheelchair users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a Hybrid Course on Wheelchair Service Provision for clinicians in international contexts. Burrola-Mendez, Y., Goldberg, M., Gartz, R., et al.[2019]

A study involving 10 participants (5 experienced powered wheelchair users and 5 expert clinicians) identified 110 distinct skills and abilities necessary for safe indoor powered wheelchair use, highlighting the complexity of this task.

The research revealed that about 50% of these skills are mental functions, and it emphasized the need for training programs to cover a wide range of skills and knowledge, including understanding oneself, the environment, the wheelchair, and the specific tasks involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Understanding the task demands for powered wheelchair driving: a think-aloud task analysis. Smith, EM., Mortenson, WB., Mihailidis, A., et al.[2022]

A study involving 28 clinicians revealed that providing wheelchair skills training for children involves considering a wide range of factors, with 1246 distinct factors identified and categorized using the International Classification of Functioning, Disability and Health (ICF) system.

Most factors (42.25%) related to the Activities and Participation domain, indicating that effective wheelchair skills training requires a comprehensive understanding of not just motor abilities, but also the child's overall participation in daily activities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors clinicians consider when providing pediatric wheelchair skills training: a modified think aloud study. Kenyon, LK., McNally, D., Ray, J., et al.[2023]

A survey of Irish health professionals revealed that while wheelchair skills training is commonly provided to new users, it primarily focuses on basic skills like transfers and simple mobility, with advanced skills being taught infrequently.

There is a strong consensus among respondents for the need to develop standardized training programs and continued education in advanced wheelchair skills to enhance the confidence and knowledge of service providers, ultimately improving mobility for wheelchair users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A cross-sectional survey investigating wheelchair skills training in Ireland. Mathis, K., Gowran, RJ.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

The IndieTrainer system: a clinical trial protocol exploring use of a powered wheelchair training intervention for children with cerebral palsy. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Short-term influence of transfer training among full time pediatric wheelchair users: A randomized trial. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Feasibility RCT protocol evaluating a powered-wheelchair training program for older adults. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Effectiveness and safety of wheelchair skills training program in improving the wheelchair skills capacity: a systematic review. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Dystonia and choreoathetosis presence and severity in relation to powered wheelchair mobility performance in children and youth with dyskinetic cerebral palsy. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Development of a Hybrid Course on Wheelchair Service Provision for clinicians in international contexts. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Understanding the task demands for powered wheelchair driving: a think-aloud task analysis. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Factors clinicians consider when providing pediatric wheelchair skills training: a modified think aloud study. [2023]

9. England pubmed.ncbi.nlm.nih.gov

A cross-sectional survey investigating wheelchair skills training in Ireland. [2023]