Getting a manual wheelchair over a threshold using the momentum method: a descriptive study of common errors

Publication date: Available online 1 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Zainab Al Lawati, R. Lee Kirby, Cher Smith, Diane MacKenzie, Chris Theriault, Kara Matheson
ObjectivesTo document the success of learners' attempts to overcome a threshold in a manual wheelchair while using the momentum method, to describe the frequency and nature of any errors observed and to compare the characteristics of participants who were or were not successful on their first attempts.DesignCross-sectional, observational study following STROBE guidelines.Participants214 able-bodied students learning the threshold skill.SettingIndoor obstacle course in a rehabilitation center.InterventionParticipants attempted to get over the Wheelchair Skills Test (WST) threshold (2 cm high, 1.5 m wide and 10 cm in the line of progression) in a manual wheelchair.Main Outcome MeasuresFrom each participant's video-recording of the first attempt, we assigned a WST score for the skill and described any errors noted.ResultsThe WST scores for the first attempts were pass for 16 (7.5%), pass with difficulty for 100 (46.7%) and fail for 98 (45.8%). Eventually, requiring up to 6 attempts, 203 (94.9%) participants were successful (pass or pass with difficulty). Twenty-six different error types were identified. Using logistic regression analysis, the Odds Ratio of failing on the first attempt for women vs. men was 2.71 (95% Confidence Interval 1.23-6.00) (p=0.0138).ConclusionOnly about half of able-bodied people learning the threshold skill using the momentum method are successful on their first attempts, although almost all are successful with further practice and feedback. During the first attempts, there are a wide variety of errors, primarily in the popping phase of the skill. Those who are successful on their first attempts are more likely to be men. These findings have implications for the assessment and training of the threshold skill.



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