- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00839098
Powered Seating Function Usage Among Veterans - Compliance and Coaching
January 5, 2016 updated by: VA Office of Research and Development
The purpose of this randomized control study is to evaluate the use of electric powered wheelchairs and powered seating function patterns of Veterans to determine how usage patterns relate to activity, participation, and seating discomfort.
In addition, it will be determined if a training program or a training program with a virtual coach will improve compliance of clinical practice guidelines for pressure relief, upper limb preservation, and discomfort management.
The virtual coach is a portable, programmable intelligent reminder designed to enhance a person's use of their power wheelchair and power seat functions.
Study Overview
Status
Completed
Detailed Description
This is a randomized control trial evaluating power seat function usage among 3 groups: 1) standard of care- verbal instruction 2) verbal and written instruction and 3) same as #2 with addition of virtual coach.
This study will be conducted in two phases.
Phase I data will be collected for 8 weeks, during the time period that the subject is awaiting for delivery of their personal electric powered wheelchair (EPW) with powered seat functions.
Phase II data will be collected for a total of 4 weeks, after the subject receives their personal wheelchair.
During Phase I, Visit I, subjects will be fitted for a study EPW with powered seat functions.
All subjects will be provided with the "standard of care" training on driving of the wheelchair and usage of the power seating functions.
Subjects will be instructed to go about their daily activities as they normally would, while the instrumented wheelchair will track their usage of the wheelchair and seating habits.
Phase I, Visit II-IV, subjects will be randomized into one of three study groups: Control Group; Instruction Group; and Instruction & Virtual Coach Group.
Subjects assigned to the Control Group will receive 'standard of care.' Subjects assigned to the Intervention Group will receive the "standard of care" and additional written instructional materials and feedback regarding activity and wheelchair usage.
Subjects assigned to the Instruction & Virtual Coach Group will receive the same training and instructional materials as the Intervention Group.
This group will also be instructed in use of the virtual coach system, which will be active during the in-home usage periods to provide personalized feedback.
Phase II will involve mounting a wheelchair and seat function usage datalogger to the subject's personal wheelchair over a period of 4 weeks.
Study Type
Interventional
Enrollment (Actual)
28
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15240
- VA Pittsburgh Health Care System
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Subjects must be 18 years of age or older.
- A power wheelchair with power seat functions must be recommended as medically necessary by a qualified clinician with ATP credential or board certified in physical medicine and rehabilitation from the VAPHS Wheelchair and Seating Clinic or the Center for Assistive Technology.
- Subjects must be able to be properly fitted with one of the study EPWs; 18" or 20" seat widths will be available. Cushions and backrests will be made available to meet subject's clinical needs.
- Subject's home must be accessible to accommodate use of a power w/c.
- Subject must be determined to be fully capable of examining his/her sitting surface daily for redness or pressure ulcers or if not that another individual can be designated as able and willing to-do this.
Exclusion Criteria:
- Subjects who have active pelvic, gluteal or thigh wounds or who have had a pressure ulcer in these regions within the past 30 days. (They may be worsened by prolonged sitting).
- Subjects who report more than 5 days of hospitalization in the previous month. (They may not spend enough time using an EPW with powered seating functions).
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: BASIC_SCIENCE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
NO_INTERVENTION: Control Group
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EXPERIMENTAL: Instruction Group
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Subjects assigned to the Intervention Group will be assigned to an Intervention Group Clinician.
The Intervention Group Clinicians will provide the same training as the Control Group Clinicians, with the addition of discussing the Veteran's activity and seating function usage data, reviewing and providing a study pamphlet and compact disk as a reference guide on use of power seat functions.
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EXPERIMENTAL: Instruction and Virtual Coach Group
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Subjects assigned to the Instruction & Virtual Coach Group will be assigned to an Intervention Group Clinician and will receive the same training and instructional materials as the Instruction Group.
Subjects will also be instructed in use of the virtual coach system, which will be active during the in-home usage periods to provide personalized feedback.
As the Virtual Coach is a dynamic intelligent system, it will adjust its coaching to the needs of the individual.
For example, if the person is compliant, the Virtual Coach will give positive feedback and then gradually transition to operating quietly in the background.
If a person is not fully compliant, it will alter feedback modes (e.g., verbal cues, auditory tones, visual cues) and timing to attempt to increase compliance.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Compliance Rate
Time Frame: Every 2 weeks for 8 weeks following acquisition of wheelchair
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Compliance rate is a measure of compliance with the recommendation of using powered seating functions (moderate or maximum range of tilt, at least once every hour, for 2 minutes).
The participant had to follow the recommended position, duration, and frequency to be considered as compliant and performed successful repositioning exercise.
The compliance rate of a participant was the number of successful repositioning exercise divided by the sum of the number of successful repositioning exercise and missed repositioning exercise.
The result of the difference between the baseline and week 7-8 (last 2 weeks) was shown here.
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Every 2 weeks for 8 weeks following acquisition of wheelchair
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Frequency of Power Seat Function Usage
Time Frame: Every 2 weeks for 8 weeks following acquisition of wheelchair
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Frequency of power seat function usage was measured by the number of times of changing tilt and recline angles averaged by the duration that the participant occupied the wheelchair per day.
The results of the difference between the baseline and week 7-8 (last 2 weeks) were shown here.
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Every 2 weeks for 8 weeks following acquisition of wheelchair
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Power Wheelchair Usage
Time Frame: Every 2 weeks for 8 weeks following acquisition of wheelchair
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Power wheelchair usage was measured by the sum of distances that the power wheelchair traveled (km) divided by the duration of the wheelchair being occupied a day (hr).
The result of the difference between the baseline and week 7-8 (last 2 weeks) was shown here.
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Every 2 weeks for 8 weeks following acquisition of wheelchair
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Wheelchair Occupancy
Time Frame: Every 2 weeks for 8 weeks following acquisition of wheelchair
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Wheelchair occupancy was measured by the sum of duration that the seat of the wheelchair was occupied.
The results of the difference between the baseline and week 7-8 (last 2 weeks) were shown here.
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Every 2 weeks for 8 weeks following acquisition of wheelchair
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Questionnaire Responses: Tool for Assessing Wheelchair Discomfort (TAWC)
Time Frame: Every 2 weeks for 8 weeks following acquisition of wheelchair
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General Discomfort Assessment (GD) and Discomfort Intensity Rating (DI) are two sub-scales of TAWC.
Higher scores indicate greater discomfort.
GD consists of 8 discomfort statements and 5 comfort statements.
The statements are rated on a seven point Likert scale, from strongly disagree to strongly agree of points from 1-7 (total score: 13-91).
DI includes seven body areas (back, neck, buttocks, legs, arms, feet, and hands) and overall discomfort level, rated for a degree of discomfort intensity on a scale of 0 (no discomfort) to 10 (severe discomfort).
Space is also included for the user to list additional body areas.
DI scores may range from 0 to more than 80, depending on whether the participant reported additional areas of discomfort.
Although GD and DI were measured daily, the data were average for each two-week period.
The average GD and DI of the difference between the baseline and week 7-8 (last 2 weeks) were shown here.
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Every 2 weeks for 8 weeks following acquisition of wheelchair
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Questionnaire Responses: Psychological Impacts of Assistive Devices Scale
Time Frame: At the end of every two weeks
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This tool is to measure perceived psychological impact of using an assistive device.
It consists of three subscales, Competence (12 items), Adaptability (6 items), and Self-esteem (8 items).
Each item is scored on a likert scale from -3 (decreases) to + 3 (increases).
The total score is the sum of all 26 items, ranging from -78 to 78.
A higher positive score indicates more positive impact.
A negative score indicates negative impact.
The differences between the measurements taken at the end of 2nd week (end of baseline) and the end of 8th week (end of intervention period) are reported here to show the intervention effect.
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At the end of every two weeks
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Questionnaire Responses: Independence in Community
Time Frame: At the end of 2nd (end of baseline) week and 8th week (end of intervention period) following acquisition of wheelchair
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This outcome was measured in three aspects: Physical Independence, Cognitive Independence, and Mobility, using the three of the subscales of Craig Handicap Assessment and Reporting Technique Scale.
The scores of each subscale has to be calculated with specific formula and weight based on the manual.
The range of each subscale score are: Physical Independence: 28-100; Cognitive Independence: 15-100; and Mobility: 16-100.
A higher score indicates greater independence.
The analyzed results of the difference between the measurements at the end of 2nd week and 8th week were shown here.
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At the end of 2nd (end of baseline) week and 8th week (end of intervention period) following acquisition of wheelchair
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
November 1, 2011
Primary Completion (ACTUAL)
December 1, 2013
Study Completion (ACTUAL)
November 1, 2014
Study Registration Dates
First Submitted
February 6, 2009
First Submitted That Met QC Criteria
February 6, 2009
First Posted (ESTIMATE)
February 9, 2009
Study Record Updates
Last Update Posted (ESTIMATE)
February 4, 2016
Last Update Submitted That Met QC Criteria
January 5, 2016
Last Verified
January 1, 2016
More Information
Terms related to this study
Other Study ID Numbers
- B6591-R
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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