The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair

Abstract

Purpose

To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness.

Methods

Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test.

Results

Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility.

Conclusions

A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.

Implications for rehabilitation

• Exercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.

• These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.

• More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.

Keywords:

• Mobility
• children
• physical behaviour
• self-efficacy
• wheelchair skills
• performance

Acknowledgements

This study is part of the Fit For the Future collaboration; H. Wittink, A. Dallmeijer, R van den Berg-Emons. We would like to thank all children, adolescents, and their parents for participation in this study. We are especially grateful to all the participating health care professionals of Rehabilitation centre: Heliomare, De Trappenberg, De Hoogstraat, Blixembosch and Roessingh and School for special education Roosendaal for organising and administering the training sessions with us. We would also like to thank KJ-Projects for sharing their expertise in training wheelchair mobility skills with us and all the participating children, parents, and health care professionals. We would like to thank Phelie Maguire for the proof reading of this manuscript and finally we would like to thank all the participating students who have enthusiastically contributed to the data collection and analysis in the Let’s ride study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by SIA Raak [ref. no. SIA RAAK PRO-4-03], Funding for Fit-For-the-Future consortium and the Dutch Foundation for Disabled Children (NSGK).