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Published on: February 5, 2020
Effectiveness of the miWe Simulator Training on Powered Wheelchair-driving Skills: A Randomized Controlled Trial
Céline Faure1, François Routhier2, Josiane Lettre1
1Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale du Québec, Quebec City, Canada.
Objectives:
To evaluate the effectiveness of a home-based simulator training, in comparison with a videogame-based training, in terms of powered wheelchair driving skills, skills use in a real-world setting, and driving confidence.
Design:
Single-blinded randomized controlled trial.
Setting:
Community.
Participants:
New powered wheelchair users (N=47) randomly allocated to simulator group (n=24, 2 drop-out) and control group (n=23, 3 drop-out).
Interventions:
The miWe wheelchair simulator (simulator group) or a kart driving videogame (control group) was setted-up at participants' homes (computer + joystick). They were instructed to use it at least 20 minutes every 2 days, during a period of 2 weeks.
Primary Outcome Measure(S):
Assessments were done at baseline (T1) and post-training (T2) using the Wheelchair Skills Test Questionnaire (WST-Q, version 4.1), Wheelchair Confidence Scale (WheelCon), Assistive Technology Outcomes Profile for Mobility, and Life-Space Assessment (LSA). The time necessary to complete 6 WST tasks was measured with a stopwatch.
Results:
Participants of the simulator group significantly increased their WST-Q capacity score at T2 by 7.5% (P<.05), whereas the control group remained at the same score (P=.218). Participants of both groups rolled backward and went through a door significantly faster at T2 (P=.007; P=.016), but their speed did not change for the other skills. The WheelCon score significantly increased after training (+4% for the control group and +3.5% for the simulator group, P=.001). There was no T1-T2 difference between groups for the WST-Q performance scores (P=.119), the ATOP-Activity (P=.686), the ATOP-Participation scores (P=.814), and the LSA score (P=.335). No adverse events or side effects were reported during data collection or training.
Conclusions:
Participants of both groups improved some skills and their wheelchair driving confidence. The simulator training group also demonstrated a modest post-training gain in their WST-Q capacity, but more studies would be needed to explore the long-term effects of the McGill immersive wheelchair simulator (miWe) simulator on driving skills.
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