Comparing performance of manual wheelchair skills using new and conventional rear anti-tip devices: randomized controlled trial.

OBJECTIVE

To test the hypotheses that, compared with participants using manual wheelchairs equipped with conventional rear anti-tip devices (C-RADs), those using a new RAD design that deploys through an arc (Arc-RAD) perform RAD-relevant wheelchair skills better and as safely.

DESIGN

A randomized controlled study.

SETTING

A rehabilitation center.

PARTICIPANTS

Participants (N=30) including 16 able-bodied and 14 wheelchair users.

INTERVENTION: Participants were provided with wheelchair skills training (up to 2.4h).

MAIN OUTCOME MEASURES: Total percentage score on a set of 23 RAD-relevant skills of the Wheelchair Skills Test (WST, version 3.2) administered a minimum of 3 days after training.

RESULTS

For the C-RAD and Arc-RAD groups, the mean +/- standard deviation RAD-relevant WST scores were 32.3%+/-8.5% and 85.1%+/-18.9% (Kruskal-Wallis, P<.001). Of the 23 RAD-relevant individual skills, the success rates for the Arc-RAD group were at least 20% higher (the criterion we set for clinical significance) in 17 (74%). For the C-RAD group, the success rate was 0% for the 12 wheelie-dependent skills, the 13-cm-high obstacle, and the 15-cm level change ascent. There were no serious adverse effects in either group.

CONCLUSIONS

The new RAD design allows much better performance on relevant wheelchair skills than the conventional design without compromising safety.