Article

OBJECTIVE: To comprehensively assess the effectiveness and safety of wheelchair
skills training program in improving wheelchair skills capacity. DATA SOURCES:
PubMed, OVID, EBSCO, ScienceDirect, Web of Science, CINAHL, Cochrane Library,
Google Scholar, and China Knowledge Resource Integrated Database were searched up
to March 2017. METHODS: Controlled clinical trials that compared a wheelchair
skills training program with a control group that received other interventions
and used the wheelchair skills test scores to evaluate wheelchair skills capacity
were included. Two authors independently screened articles, extracted data, and
assessed the methodological quality using the Cochrane risk-of-bias tool in
randomized controlled trial (RCT) and methodological index for non-randomized
studies. The data results of wheelchair skills test scores were extracted.
RESULTS: Data from 455 individuals in 10 RCTs and from 140 participants in seven
non-randomized studies were included for meta-analysis using Stata version 12.0
(Stata Corporation, College Station, TX, USA). In the short term (immediately to
one week) post-intervention, relative to a control group, manual wheelchair
skills training could increase the total wheelchair skills test scores by 13.26%
in RCTs (95% confidence interval (CI), 6.19%-20.34%; P < 0.001) and by 23.44% in
non-randomized studies (95% CI, 13.98%-32.90%; P < 0.001). Few adverse events
occurred during training; however, compared with a control group, evidence was
insufficient to support the effectiveness of powered wheelchair skills training
and the long-term (3-12 months) advantage of manual wheelchair skills training (
P = 0.755). CONCLUSION: The limited evidence suggests that wheelchair skills
training program is beneficial in the short term, but its long-term effects
remain unclear.

Langue : ANGLAIS