BACKGROUND;-The wheel chair skills training program (WSTP) is a structured protocol that incorporates several principles of motor learning. Extensive motor learning literature suggests effective methods of facilitating long term retention of skills in Rehabilitation settings. The WSTP has been shown to be an effective addition to conventional wheel chair training during the initial rehabilitation of wheelchair users (84) and in the training of able-bodied subjects acting as caregivers.OBJETIVES;-To investigate the effectiveness of Modified Wheelchair skills training program (MWSTP) on energy expenditure in patients with spinal cord injury over conventional wheelchair training programDESIGN:Pre test post test control group design.SETTING Occupational Therapy department, Inpatient Rehabilitation ward, National Institute for the Orthopaedically Handicapped (NIOH), B.T.Road, KOLKATA – 90, West Bengal.PARTICIPANTS Study was conducted on a convenient sample of 30 participants from Spinal cord injury population attending outpatient Occupational Therapy department, Inpatient Rehabilitation ward, All the patients were randomly allocated into two groups of 15 each. In Experimental group mean age is 37.93 and standard deviation of 4.63.In Control group mean age is 35.93 and standard deviation of 4.39.Experimental Group and Control Group consists of 12male and 3 female each.INTERVENTIONAll the patients were randomly allocated into two groups of 15 each. Group A was the experimental group (conventional training+Modified wheel chair skills training). Group B was the control group (Conventional Training alone). The subjects in both the groups underwent a 60 days wheelchair skills training program. Subjects trained five times a week. Each training sessions lasted 30 minutes. Sessions were recorded in 5min increments and at the end of each 5min period; the skill training being practiced at that time was recorded. The first 20min of each session was dedicated to learning skills according to training curriculum. Practice took place in a blocked manner (repeatedly) until a particular skill was successfully completed. During practice, subjects had two attempts to complete the task. If the skill was successfully completed during either attempt; training of next appropriate skill began. Evaluation of entire outcome measures both pre test and post test training were done by another therapist unaware of the study results.MAIN OUTCOME MEASURES Energy expenditure, Heart rate, Oxygen consumption.RESULTS Between group analysis suggested that for oxygen values for pot 30 days training was (p<0.11), 60 days training p(<0.24) same as Heart rate T30 (p<0.16), T60(p<0.21) Energy expenditure T30(p<0.85) and T60(p<0.11)and energy expenditure Though the result suggests that the both of the training are effective in reducing HR, O2 consumption and EE post training, but there was a significant difference found between both the groups, suggesting modified wheel chair skills training program to be better over conventional wheel chair training.CONCLUSIONS The use of MWSTP can be recommended in rehabilitation settings instead of conventional wheelchair training for the SCI patients as there is a significant decrease in O2 consumption, HR and EE in MWSTP group over conventional training. Thus the MWSTP is a safe, practical and effective method of improving wheelchair skills knowledge and performance. It has also a clinically significant effect on the independent wheeled mobility of new wheelchair users. These findings have implications for the standards of care and clinical use in rehabilitation program.
The wheel chair skills training program, spinal cord injury, Energy expenditure, Heart rate, Oxygen consumption. Convenient sample, motor learning
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