Are wheelchair-skills assessment and training relevant for long-standing wheelchair users? Two case reports

We present two case reports that shed light on the question of whether routine periodic wheelchair-skills assessment and training are relevant for long-standing wheelchair users. CASE 1: A 60-year-old man with a 15-year history of T12 complete paraplegia sustained an intertrochanteric fracture of his femur due to a tip-over accident that occurred 2 days after a follow-up clinic visit at which no limitations in wheelchair-skill performance were identified. If a procedure had been in place to identify and correct his wheelchair-skill deficiencies, this injury might have been prevented. CASE 2: A 34-year-old woman with spina bifida, whose wheelchair use had gradually increased, came to our attention during the provision of a new wheelchair. She was able to significantly improve her wheelchair abilities through training. The newly learned skills enhanced her community participation.

These cases suggest that, even in long-standing wheelchair users, wheelchair skills should be routinely assessed as part of the periodic functional assessment and, when the skill level is determined to be less than appropriate for that person, formal training should be offered.