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Manual wheelchair-handling skills by caregivers using new and conventional rear anti-tip devices: a randomized controlled trial
Kirby RL, Walker R, Smith C, Best K, MacLeod DA, Thompson K
Archives of Physical Medicine and Rehabilitation 2009 Oct;90(10):1680-1684
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To test the hypothesis that, in comparison with caregivers handling manual wheelchairs equipped with conventional rear anti-tip devices (C-RADs), those using a new design (Arc-RADs) perform relevant wheelchair skills better and as safely. DESIGN: Randomized controlled trial. SETTING: Rehabilitation center. PARTICIPANTS: Caregivers (n = 16) and the wheelchair users (n = 16) for whom they cared. INTERVENTION: Participants were trained in wheelchair-handling skills for an average of 54 minutes each. MAIN OUTCOME MEASURES: Total percentage score on a set of 20 rear anti-tip device- and caregiver-relevant skills from the Wheelchair Skills Test, version 3.2, administered a minimum of 3 days after training. RESULTS: For the C-RAD and Arc-RAD groups, the mean +/- SD Wheelchair Skills Test scores were 40% +/- 0% and 98.8% +/- 3.5%, respectively (p < 0.001). Skills that required the wheelchair to be tipped back extensively (eg, for ascending a 15cm curb) accounted for the differences between the groups. There were no adverse effects in either group. CONCLUSIONS: The Arc-RAD design allows significantly better caregiver wheelchair-handling skills than the conventional design, without compromising safety.

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