Manual Wheelchair Speed, Maneuverability, and Endurance and Community Access

This is a cross-section correlational study that will examine the relationships between wheelchair speed, maneuverability, and endurance with community integration. By identifying which of these has the biggest contribution to community participation, the information will be used to justify continues therapy, to alter the focus of therapy, and to justify purchase of power or power assist wheelchairs when needed. Currently, therapists make the recommendation for a power or power assist chair based on their clinical judgement and the patient's experience, but there has been limited justification from the literature for these decisions. Finally, because the CHART measure is the gold standard in rehabilitation research for community integration, but has psychometric problems, we will use this opportunity to validate a new more psychometrically solid measure, the PART-O, against the CHART.

Study Overview

• Status: Terminated
• Conditions: Physical Disability
• Intervention / Treatment: Other: Life Space Assessment Scale; Other: 6-Minute Push Test; Other: Forward Push Test; Other: Wheelchair Slalom Test; Other: Craig Handicap Assessment and Reporting Technique; Other: PART-O; Other: GPS Tracking

• Study Type: Observational
• Enrollment (Actual): 1

Contacts and Locations

Study Locations

• United States
  • Minnesota
    • Golden Valley, Minnesota, United States, 55422
      • Courage Kenny Rehabilitation Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

260 participants with disabilities who use manual wheelchairs for their primary mobility. Participants will be recruited from all Courage Kenny Rehabilitation Institute sites. Participants will have a mixture of diagnosis, with a minimum of 30 individuals with diagnosis of stroke and 30 individuals with diagnosis with spinal cord injury.

Description

Inclusion criteria include:

• 18 years or older
• presence of a physical disability
• use of a manual wheelchair for primary mobility
• living in the community.

Exclusion criteria would include:

• individuals who have significant expressive or receptive language deficits (i.e. aphasia, verbal apraxia, etc.)
• limb orthopedic conditions that would contraindicate speed and endurance testing, such as recent fractures or joint instability
• cardiopulmonary resting heart rate of less than 50 or over 100, resting vitals of systolic blood pressure of > 200 or < 90, diastolic blood pressure of >110, resting O2 levels of less than 90 (ACSM, 205; Fletcher, et al., 1993).
• any other cardiac symptoms

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Wheelchair Mobility and Speed; This group will participate in activity-based measures employed in routine occupational and physical therapy practice to assess participants' wheelchair speed, maneuverability, and endurance. These measures include: the Life Space Assessment Scale, 6-Minute Push Test, Forward Push Test, Wheelchair Slalom Test, Craig Handicap Assessment and Reporting Technique, and PART-O.	Other: Life Space Assessment Scale; This nine question survey asks participants where they have gone in the last week, frequency of those visits, and how independently they went there.; Other: 6-Minute Push Test; The 6 Minute Push Test is a measure of endurance, and requires that the participant wheel themselves around two pylons that are located 15 meters apart for 6 minutes.; Other: Forward Push Test; This measure of wheelchair propulsion speed asks patients to propel themselves as fast as they can over 20 meters. This task is performed twice, and the average time is used for the score.; Other: Wheelchair Slalom Test; In this measure, participants propel themselves through an 18 meter slalom course at their maximum self-selected speed, wheeling around seven cones, separated by three, two, or one meter.; Other: Craig Handicap Assessment and Reporting Technique; A measure of social participation in individuals with SCI.; Other: PART-O; The PART-O is a community participation measure.
GPS Tracking; A GPS tracker will be placed on the wheelchairs of 25 individuals who consent to participate in this arm of the project. Using a GPS tracker will provide a direct measure of the community locations these participants go. The GPS location is collected every minute, and mapped to Google Maps, which would allow calculation of speed of movement.	Other: Life Space Assessment Scale; This nine question survey asks participants where they have gone in the last week, frequency of those visits, and how independently they went there.; Other: 6-Minute Push Test; The 6 Minute Push Test is a measure of endurance, and requires that the participant wheel themselves around two pylons that are located 15 meters apart for 6 minutes.; Other: Forward Push Test; This measure of wheelchair propulsion speed asks patients to propel themselves as fast as they can over 20 meters. This task is performed twice, and the average time is used for the score.; Other: Wheelchair Slalom Test; In this measure, participants propel themselves through an 18 meter slalom course at their maximum self-selected speed, wheeling around seven cones, separated by three, two, or one meter.; Other: Craig Handicap Assessment and Reporting Technique; A measure of social participation in individuals with SCI.; Other: PART-O; The PART-O is a community participation measure.; Other: GPS Tracking; A GPS tracker will be attached to the wheelchairs of a subset of participants for one week. The GPS location is collected every minute, and mapped to Google Maps, which would allow calculation of speed of movement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Life Space Assessment Scale Score	This nine question survey asks participants where they have gone in the last week, frequency of those visits, and how independently they went there. The locations vary from spaces within their home, immediately around their home, or outside of their neighborhood, city, county, state or nation. Their independent movement patterns will be classified as within the home, limited community mobility and full community mobility.	Day 0

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Distance (meters) covered in six-minute push test	This is a measure of endurance, and requires that the participant wheel themselves around two pylons that are located 15 meters apart for 6 minutes	Day 0
Average time to complete forward push test	This measure of wheelchair propulsion speed asks patients to propel themselves as fast as they can over 20 meters. This task is performed twice, and the average time is used for the score	Day 0
Time to complete Manual Wheelchair slalom Test	In this measure, participants propel themselves through an 18 meter slalom course at their maximum self-selected speed, wheeling around seven cones, separated by three, two, or one meter	Day 0

Collaborators and Investigators

• Sponsor: Allina Health System
• Investigators: Principal Investigator: Nancy Flinn, PhD, OTR/L, Allina Health

Study record dates

Study Major Dates

• Study Start (Actual): March 31, 2018
• Primary Completion (Actual): February 1, 2021
• Study Completion (Actual): February 1, 2021

Study Registration Dates

• First Submitted: March 12, 2018
• First Submitted That Met QC Criteria: March 15, 2018
• First Posted (Actual): March 19, 2018

Study Record Updates

• Last Update Posted (Actual): February 15, 2021
• Last Update Submitted That Met QC Criteria: February 11, 2021
• Last Verified: February 1, 2021

More Information

Terms related to this study

• Other Study ID Numbers: CKNF-1703

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No