Efficacy of Manual Wheelchair Skills Training for Improving Skills and Confidence in People With Hereditary Degenerative Disorders: Protocol for a Sequential Multimethods Study (Preprint)
Notice bibliographique
Résumé
BACKGROUND Mobility impairment and participation restrictions are commonly experienced by individuals with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) and myotonic dystrophy type 1 (MD1), 2 disorders that are highly prevalent in the province of Quebec, Canada. People with ARSACS and MD1 experience a progressive decline in mobility, which commonly results in the provision of manual or power wheelchairs. While wheelchairs can facilitate mobility and social participation, their provision alone does not guarantee safe and effective use. Wheelchair skills training has been shown to be effective for improving manual skills and confidence among adult users with various diagnoses, which may enhance self-directed mobility and participation and reduce the risk of chronic and acute injuries. However, manual wheelchair skills training for people with ARSACS and MD1 remains understudied. OBJECTIVE The primary aim of this study is to evaluate the efficacy of manual wheelchair skills training for safely improving wheelchair performance in people with ARSACS and MD1. The secondary outcomes include exploring the influence of manual wheelchair skills training on skill capacity, use self-efficacy, mobility, and the retention of outcomes 3 months later. We will also qualitatively explore the manual wheelchair training experiences of people with ARSACS and MD1. METHODS This study will use a sequential multimethods design, combining a waitlist randomized controlled trial and qualitative interviews. The participants will include adults who have a diagnosis of ARSACS or MD1 who use a manual wheelchair for mobility. Participants will be randomly assigned to the intervention or control group using a 1:1 allocation ratio. The intervention group will receive 5 manual wheelchair skills training sessions (1-2 sessions/week), while the control group will receive no training. Data will be collected at baseline (T1), after the 4-week intervention (or waiting period for the control group; T2), and 3 months after T2 to assess retention (T3). The primary outcome will be manual wheelchair skills performance. Secondary outcomes will include manual wheelchair skills capacity, self-efficacy, and mobility. Semistructured individual interviews will be conducted to explore participants’ expectations regarding manual wheelchair use, past manual wheelchair experiences, and perceptions of manual wheelchair skills training. Quantitative data will be analyzed using analysis of covariance (ANCOVA), controlling for baseline scores, and qualitative data will be analyzed using reflexive thematic analysis. RESULTS This study received ethical approval (2025-3100) in July 2024. Recruitment started in January 2025. A graduate student, a research assistant, and a research coordinator have been recruited and trained. CONCLUSIONS The results of this randomized waitlist-controlled trial will confirm whether manual wheelchair skills training can improve self-directed mobility and related outcomes for people with ARSACS and MD1. The findings may help guide clinical practice toward manual wheelchair skills training for understanding potential influences on manual wheelchair mobility in people living with neuromuscular disorders. CLINICALTRIAL ClinicalTrials.gov NCT06596850; https://clinicaltrials.gov/study/NCT06596850 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/66974
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,024 | 0,022 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,003 |
| Méta-épidémiologie (sens large) | 0,007 | 0,008 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,004 | 0,002 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,004 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,062 | 0,009 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».