Ms Kimberly Charlton1, Dr Carolyn Murray2, Dr Natasha Layton3, A/Prof Stacie Attrill1
1University of Adelaide, Adelaide, Australia, 2University of South Australia, Adelaide, Australia, 3Monash University, Melbourne, Australia
Biography:
Kimberly is a PhD candidate and lecturer in Occupational Therapy at the University of Adelaide. Kimberly worked clinically as an Occupational Therapist, before commencing at the University in the area of subacute and community rehabilitation with specialised skills in amputee rehabilitation, geriatrics, orthopaedics and falls. Her PhD is looking at informing better manual wheelchair training within practice.
Abstract:
Background:
Manual wheelchair (MWC) training is crucial for individuals commencing wheelchair use due to chronic conditions. Effective training can improve independence and engagement in meaningful activities and reduce injury risk, caregiver burden and reliance upon healthcare services. However, not all training contexts yield positive outcomes for all MWC users. This study describes the development of theories to provide insight into the contexts and mechanisms that underpin successful MWC training outcomes.
Method:
A realist approach synthesised evidence from primary studies (n=46) and stakeholder interviews (n=17) to explore contexts underlying manual wheelchair training effectiveness. Contexts, mechanism and outcomes were extrapolated and retroductive analysis was used to build context-mechanism-outcome configurations. Demi-regularities were identified allowing for the iterative refinement of theories explaining how and why training succeeds across different settings.
Results:
This synthesis identified multiple important contexts that contribute to positive outcomes for MWC users; controlled training environments, proper wheelchair fitting, and caregiver inclusion enhances wheelchair users’ perceived safety, fostering engagement and skill improvement. Peer-led, group training and positive attitudes promote psychological safety, while vicarious learning boosts acceptance and skill development. Training in relevant, goal-aligned settings increases motivation, confidence, and community navigation. Technological aids like visual biofeedback support skill acquisition and propulsion efficiency.
Discussion/Implications:
For allied health professionals understanding what works for who and why is essential for designing effective MWC training programs. These findings provide insights into contexts and mechanisms that support successful training outcomes, enabling allied health professionals to tailor interventions to maximise safety, independence and quality of life for wheelchair users.