title: Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To test the hypotheses that community-dwelling veterans with spinal cord injury (SCI) who receive the Wheelchair Skills Training Program (WSTP) in their own environments significantly improve their manual wheelchair-skills capacity, retain those improvements at one year and improve participation in comparison with an Educational Control (EC) group.
  
  
  METHODS
  We carried out a randomized controlled trial, studying 106 veterans with SCI from three Veterans Affairs rehabilitation centers. Each participant received either five one-on-one WSTP or EC sessions 30-45 minutes in duration. The main outcome measures were the total and subtotal percentage capacity scores from the Wheelchair Skills Test 4.1 (WST) and Craig Handicap Assessment and Reporting Technique (CHART) scores.
  
  
  RESULTS
  Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001) and retained their scores at one year follow-up. The success rates for individual skills were consistent with the total and subtotal WST scores. The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021).
  
  
  CONCLUSIONS
  Individualized wheelchair skills training in the home environment substantially improves the advanced and total wheelchair skills capacity of experienced community-dwelling veterans with SCI but has only a small impact on participation.
authors.affiliation: Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
authors.forename: R Lee
authors.identifier: http://orcid.org/0000-0002-0005-1209
authors.initials: RL
authors.lastname: Kirby
authors.affiliation: Charlie Norwood Veterans Administration Medical Center, Augusta, Georgia, United States of America.
authors.forename: Doug
authors.initials: D
authors.lastname: Mitchell
authors.affiliation: Veterans Administration Boston Health Care System and Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Sunil
authors.initials: S
authors.lastname: Sabharwal
authors.affiliation: Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, College of Public Health, University of South Florida, Tampa, Florida, United States of America.
authors.forename: Mark
authors.initials: M
authors.lastname: McCranie
authors.affiliation: Health Services Research & Development Center of Innovation on Disability and Rehabilitation Research (CINDRR), James A. Haley Veterans' Hospital, College of Public Health, University of South Florida, Tampa, Florida, United States of America.
authors.forename: Audrey L
authors.initials: AL
authors.lastname: Nelson
mesh_terms: D000328:Adult; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013647:Task Performance and Analysis; D014728:Veterans; D014910:Wheelchairs