Article

OBJECTIVES: To determine if strict use of the Paralyzed Veterans of America's
Clinical Practice Guidelines for Preservation of Upper Limb Function affects
wheelchair setup, selection, propulsion biomechanics, pain, satisfaction with
life, and participation of individuals with new spinal cord injuries (SCIs).
DESIGN: Single blinded, randomized controlled trial. SETTING: Model SCI systems
rehabilitation facility and community. PARTICIPANTS: Volunteer sample of manual
wheelchair users with new SCIs (N=37). INTERVENTION: The intervention group was
strictly educated on the clinical practice guideline by a physical therapist and
an occupational therapist in an inpatient rehabilitation facility. The standard
of care group received standard therapy services. MAIN OUTCOME MEASURES:
Comparison of wheelchair setup, selection, propulsion biomechanics, pain, and
Satisfaction With Life Scale and Craig Handicap Assessment and Reporting
Technique scores at the time of discharge from inpatient rehabilitation and at 6
months and 1 year postdischarge. RESULTS: Participants in the intervention group
pushed on tile with significantly lower push frequency (P=.02) at the discharge
visit. On the ramp, the intervention group used a significantly larger push
length (P=.03) across all time points. No significant differences were found
between groups related to wheelchair setup, selection, pain, satisfaction with
life, and participation. CONCLUSIONS: The intervention group showed better skills
on key wheelchair propulsion biomechanics variables related to upper-limb health.
Use of a structured education program may be an effective method of educating new
manual wheelchair users to prevent the development of upper-limb impairments in
an inpatient setting. Additional follow-up testing is necessary to determine
whether the differences seen in propulsion skills translate into decreased pain
and improved quality of life in the long term.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS