A feasibility study of a shared control powered wheelchair training program for individuals with spinal cord injury.

OBJECTIVES

To evaluate the feasibility of the Collaborative Power Mobility Innovative Learning OpporTunity (CoPILOT) wheelchair training protocol and intervention among new powerchair users with spinal injuries, focusing on feasibility metrics and clinical outcomes.

STUDY

DESIGN

An evaluator-blind, parallel randomized controlled trial.

SETTING

Rehabilitation hospital/community setting in Vancouver, Canada.

METHODS

Participants were randomized to CoPILOT or control group (the Wheelchair Skills Program (WSP)). Trained occupational therapists conducted sessions. Data included demographics and feasibility metrics (process, resource, management, treatment safety), as well as primary (Power Mobility Indoor Driving Assessment-PIDA) and secondary outcomes: Wheelchair Skills Test Questionnaire for Powered Wheelchairs-WST-Q-P (capacity and performance subscales), the Wheeling While Talking-WheelTalk task, and the Wheelchair Use Confidence Scale for Powered Wheelchair Users-WheelCon-P (Mobility and Social sub scores).

RESULTS

10 participants (9 male), mean age (SD) was 56.9 years (17.40), and all had prior manual wheelchair use. Attendance (SD) averaged 7.75 sessions (3.49) for CoPILOT group and 8.8 (3.70) for the WSP group. Both groups had baseline and final PIDA scores above 90%. On the WST-Q-P capacity subscale, CoPILOT improved by 8.25% (SD = 19.75), whereas WSP improved by 10.8% (SD = 9.86); on the performance subscale, CoPILOT improved by 8.00% (SD = 19.88) compared to 19.8% (SD = 24.52) for WSP. WheelTalk times, rose by 36.16 s (SD = 45.71) in CoPILOT but declined by 33.46 s (SD = 36.58) in WSP. For WheelCon-P, Mobility sub score increased by 26.75 (SD = 15.33) in CoPILOT versus -18.2 (SD = 77.24) in WSP, and Social sub score changed by -5 (SD = 6.93) versus 4 (SD = 11.94), respectively. The retention rate was 90%, yet neither group achieved the ≥80% session-adherence goal.

CONCLUSION

CoPILOT showed promise in improving wheelchair skills and safety for new powerchair users with spinal injuries. However, recruitment and adherence challenges indicate a need for improved engagement and delivery methods. Further robust RCTs could compare CoPILOT's effectiveness with standard care.

CLINICAL TRIAL REGISTRY: ClinicalTrials.gov ID: NCT02320786.