PTOTSystematic ReviewAustralian occupational therapy journal2025

Manual wheelchair training approaches and intended training outcomes for adults who are new to wheelchair use: A scoping review.

Kimberly Charlton, Carolyn Murray, Natasha Layton and 4 others

PMID 39351679

WHAT IT FOUND

Most wheelchair training programs for adults focus on basic skills, confidence, and propulsion mechanics rather than long-term community participation.

They rarely address the needs of older adults with progressive conditions or those with cognitive impairments, leaving therapists without clear guidance on effective, tailored approaches.

Key findings

01The majority of included papers captured outcomes immediately following delivery of MWC training or within four weeks post-training, with very few assessing long-term participation.

02Existing literature predominantly targets wheelchair users with spinal cord injury and younger demographic groups, often excluding those with progressive conditions or reduced cognition.

03Training approaches lack consistency in design, frequency, and length, and are often delivered in inpatient or laboratory settings rather than the community environments where users actually need skills.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The review was limited to English-language papers, potentially excluding training programs from non-Western contexts. It excluded studies involving able-bodied persons simulating wheelchair use, clinicians, students, and paediatric users, meaning some training approaches were not captured. Grey literature was searched, but unpublished or proprietary protocols developed by service organizations may have been missed. The included literature is heavily dominated by spinal cord injury populations, limiting generalizability to other conditions like stroke, dementia, or multiple sclerosis.

Declared interests

One co-author, Dr Carolyn Murray, is an Associate Editor for the journal publishing this review. She was anonymized during the peer review process, and the Editor-in-Chief managed the review and decision-making.

The easy way to misread this

Do not assume that short-term improvements in wheelchair skills or confidence reported in these studies translate to long-term community participation or independence. Most programs were evaluated immediately or within four weeks, and few addressed the specific needs of older adults with progressive conditions or cognitive impairments.

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