Developing wheelchair training program for rehabilitation and occupational therapy students

Abstract

Assistive Technology devices enable persons with disabilities to function in variety of contexts and activities.1 The wheelchair is viewed as one of the most common and most important assistive technology devices used in rehabilitation.2 Wheelchairs, both manual and power, are enablers of community participation and are used to enhance function, to improve independence, and to enable a person to successfully live at home and in the community.3 Wheelchair evaluation is a continuous process requiring re-assessment of wheelchair fit as users age and their functional conditions change.4 Research has shown that during this thorough process, clinicians need to take factors into consideration that are associated with functional performance, such as wheelchair characteristics and client demographics. It is the dynamic interactions between these factors that pose the challenge for clinicians and wheelchair users as they decide on the best wheeled mobility interventions.5 Although clients seeking a wheeled mobility device are assessed before a device is prescribed, research has not focused on the everyday functional performance of the clients with their wheelchairs. Rather, instead of focusing on the ability of the device to enable activities and participation, research has focused on a wheelchair skills, propulsion, abandonment, cost, policy, and wheelchair design.6 There is a need for wheelchair personnel and the lack of trained wheelchair service provision professionals is universal. The Convention on the Rights of Persons with Disabilities (CRPD) highlights the responsibility of states to ensure personal mobility and to promote the availability of and access to such devices. It is estimated that 70 million people require wheelchairs worldwide, yet only 5-15% of people have access. Wheelchair service provision is very underdeveloped across the world. People in developing countries often depend on the donation of wheelchairs, which are frequently of poor quality and neither suitable nor customized either for the users or their environment. Health and rehabilitation professionals are not always trained adequately to ensure people with disabilities get a quality wheelchair.6 There is great variability and inconsistency in what and how wheelchair related content is taught and evaluated. A need for global standardization of wheelchair service provision education is crucial. Therefore, and after extensive expert consultations, field trials and an expert review, the World Health Organization (WHO) in partnership with the United States Agency for International Development (USAID), developed the Wheelchair Service Training Packages Basic level (WSTP-b) and Intermediate Level (WSTP-I) during the period from 2015 until 2017.7 WHO training packages serve as guides for wheelchair service provision education worldwide. However, they are not yet taught in all countries, especially in lowresourced countries.8