The IndieTrainer system: a small-scale trial exploring a new approach to support powered mobility skill acquisition in children.
Lisa K Kenyon, John P Farris, Lindsey Veety and 7 others
PMID 38450569WHAT IT FOUND
Children with severe mobility limitations using a device that turns their manual wheelchair into a power trainer showed significant gains in understanding and executing power wheelchair skills.
Parents reported high satisfaction. However, without a control group, it is unclear if the device itself caused these improvements.
Key findings
01All 25 participants achieved clinically significant improvements in their understanding of how to use a power wheelchair, moving at least one stage forward on the Assessment of Learning Powered mobility use scale.
02Participants also showed statistically significant improvements in power wheelchair skill execution and parental perceptions of their child's performance, with these gains retained four weeks after the training ended.
03Parents reported high satisfaction with the system, particularly valuing that their child remained in their own familiar wheelchair during training rather than using a generic demo device.
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 study was open-label and single-arm, meaning there was no control group and no randomization. This makes it impossible to determine if the improvements were due to the IndieTrainer system or simply from any form of power mobility practice or maturation. Outcome assessors were not blinded to the intervention, which introduces a risk of bias in the scoring of the ALP and Wheelchair Skills Checklist. The sample size was small (25 participants) and the intervention duration was short (6 hours total). The results may not generalize to children with different ages, diagnoses, or cognitive abilities. Intervention fidelity was not measured, so it is unclear how consistently the training was delivered across participants. Two children became distressed by the video games and had to stop using that component, highlighting that the gamified approach is not suitable for all learners.
Declared interests
The authors reported no competing interests to declare. The study was supported by the National Institutes of Health (Extramural).
The easy way to misread this
Do not interpret the significant improvements as proof that the IndieTrainer system is more effective than other power mobility training methods. Because there was no control group and the assessors were not blinded, the gains could be due to the practice itself, natural development, or observer bias rather than the specific features of this device.