Page 5

N - Wheeled Mobility

Figure 4.0. Histograms showing number and variety of profesionals providing (4.0 a) whelchair skils training and (4.0 b) specialized seating services, acros E-Scan sites. 0 2 4 6 8 10 12 Figure 4.0 a Occupational Therapist OTA Physiotherapist PTA Nurse (RN) Mobility Equipment Suppliers/Vendors Kinesiologist Rehabilitation Assistant Therapeutic Recreation Specialist Physiatrist Researcher Dietitian 0 2 4 6 8 10 12 Occupational Therapist OTA/Technician Orthopaedic Surgeon Physiatrist Physiotherapist Figure 4b Figure 4.0 b Mobility Equipment Suppliers/Vendors External Consultants Adequacy of Service Provision Number of Sites Number of Sites In general, most sites perceive that they have adequate service provision, for wheelchair skill development, as ten sites or greater (≥83.3%) report adequate wait times, and adequate overall service - with the minor exception of stair training, where nine sites (75%) report adequate overall service. Seating service delivery was deemed less satisfactory, as seven sites (58.3%) report adequate wait times, and nine sites (75%) indicate adequate overall service. OTs are involved at all sites (100%) and PTs, at all but one site (n=11, 91.7%) but in a lesser number of training categories. OT assistants, PT assistants, and general rehabilitation therapy assistants support these professionals at six (50%) sites. Nurses also conduct some aspects of skills training at four (33%) sites (most often involving caregiver training). Less frequently (one or two sites), physiatrists, kinesiologists, mobility equipment suppliers/vendors, clinical dietitians, therapeutic recreation specialists and researchers are involved in some aspects of wheelchair skills training. For seating service delivery (Figure 4.0 B), all sites (n=12) report having OTs, and six sites (50%) report having PTs involved, in addition to other providers such as OT assistants, physiatrists, mobility equipment suppliers/vendors and/or external consultants. Although not indicated, within the data specific to seating service provision, eight (67.6%) sites report having personnel who provide assessment and/or authorization to funders for assistive devices; and rehabilitation engineers or technicians, at six (50%) of the sites. Where available, rehabilitation engineers typically act as technical resources to the therapists, to customize mobility device components (e.g., joysticks, wheelchair set up), to better meet individual needs. Clinical Protocols for Wheelchair Skill Development and Seating Services Wheelchair skills training may encompass many distinct components, ranging from several discrete skills (for either manual or power wheelchair users), to generalization of skills, in a variety of environments, or in response to other challenges. In addition, training may be directed at the wheelchair user or future caregivers. Eight sites (66.7%) report a protocol to address at least some of these components. However, there is some uncertainty if the indicated protocols were standardized and validated, as there was much variability in reporting, across various components of wheelchair skills training. For most components, three sites (25%) indicate using the Wheelchair Skills Training Program.3 However, up to six sites (50%) report applying this protocol to manual wheelchair skill development. Even fewer sites identify following clinical protocols, relative to their seating service delivery, and there was no protocol identified at some sites (n=2). Additionally, nine sites (75%) identify using some form of wheelchair skills testing, as part of routine assessment, although it is unclear if this consists of non-standardized testing of this construct, or use of a validated tool, such as the Wheelchair Skills Test.4 One site (8.3%) reports using the Wheelchair Outcome Measure tool to assess outcomes, from the client perspective, and two sites (16.7%) indicate ongoing informal testing associated with customization of power or manual chairs. The use of standardized tools is recommended for building consistent, competent practice across Canada, which ultimately affects the health and wellness of the person with SCI. 142 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


N - Wheeled Mobility
To see the actual publication please follow the link above