Wheelchair Curb Climbing: Randomized Controlled Comparison of Highly Structured and Conventional Training Methods

Objectives: Our primary objective was to test the hypothesis that a highly structured training method for wheelchair curb-climbing requires less training time than conventional training. Our secondary objectives were to test the hypotheses that this training method increases success rate, reduces the need for spotter interventions, and reduces the participants' perceptions of difficulty. Design: Randomized controlled trial. Setting: Rehabilitation center. Participants: Able-bodied participants (N=16), randomly allocated to intervention (n=7) and control (n=9) groups. Interventions: Both groups received up to 5 training sessions. Each session included instruction, practice, and feedback. The participants in the intervention and control groups used 18- and 9-step approaches, respectively. Training in the intervention group also included video demonstration, trainer demonstrations, mirror feedback, and standardized feedback phrases. Main Outcome Measures: Total training, time. success rate at climbing a 15cm-high curb. the number of spotter interventions during training, and a questionnaire. Results: The mean +/- SD training times for the successful participants in the intervention and control groups were 42.5 +/- 24.4 minutes and 87.4 +/- 45.3 minutes (P=.084). The curb-climbing Success rates of the intervention and control groups were 86% and 89% (P=1.000). There were no significant differences between the groups regarding the number of spotter interventions (P=.203) or for participants' perceptions of difficulty (P=.050). Conclusions: In comparison with a conventional method for curb-climbing, a highly structured method seems to require less than 50% of the training time for able-bodied participants, although this finding is only a trend statistically. This has implications for clinical training.