Journal:Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):14, 95, 1, 10-19, 19.e1-19.e11
Study examined the effect of the Paralyzed Veterans of America’s Clinical Practice Guidelines for Preservation of Upper Limb Function on wheelchair setup, selection, propulsion biomechanics, pain, satisfaction with life, and participation in individuals with new spinal cord injuries (SCIs). A single-blind, randomized controlled trial was completed by 37 manual wheelchair users with new SCIs enrolled in Model SCI System rehabilitation facilities. The intervention group was strictly educated on the clinical practice guideline by a physical therapist and an occupational therapist in an inpatient rehabilitation facility. The standard of care group received standard therapy services. Analysis compared wheelchair setup, selection, propulsion biomechanics, pain, and Satisfaction With Life Scale and Craig Handicap Assessment and Reporting Technique scores between the two groups at the time of discharge from inpatient rehabilitation and at 6 months and 1 year postdischarge. Participants in the intervention group pushed on tile with significantly lower push frequency at the discharge visit. On the ramp, the intervention group used a significantly larger push length across all time points. No significant differences were found between groups related to wheelchair setup, selection, pain, satisfaction with life, and participation. The intervention group showed better skills on key wheelchair propulsion biomechanics variables related to upper-limb health. The results suggest that the use of a structured education program may be an effective method of educating new manual wheelchair users to prevent the development of upper-limb impairments in an inpatient setting.