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Participation and confidence in older manual wheelchair users

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By Lynda Bennett

This is a summary of a paper published by a group of researchers at the GF Strong Rehabilitation Research Lab in Vancouver, British Columbia, in the Archives of Physical Medicine and Rehabilitation.

Original article: Sakakibara BM, Miller WC, Eng JJ, Backman CL, Routhier F. Preliminary examination of the relation between participation and confidence in older manual wheelchair users. Arch Phys Med Rehabil. 2012 Sep 27. pii: S0003-9993(12)00990-2. doi: 10.1016/j.apmr.2012.09.016.   [Drs. Eng and Miller are ICORD Principal Investigators, and Brodie Sakakibara is a PhD Candidate with Dr. Eng.]

Adults and older adults make up 90% of Canadian wheelchair users, and more than half of them require assistance in using their wheelchair and with various activities of daily living. Why is this so?

Much of the literature exploring wheelchair use only considers the environment or the physical attributes of the wheelchair user. One of the most important factors is often overlooked: self-confidence. This study demonstrates that a person’s self-confidence is a strong predictor of participation in many life activities.

What was the most important finding?

For older manual wheelchair users, belief in the ability to use a manual wheelchair is a positive indicator of the regularity of participation in many other activities. It may be that low confidence with wheelchair use might lead to self-imposed restrictions. In males, the relationship between self-confidence and regular participation is stronger than that in females.

What are some things we need to consider?

The participants in this study were 50 years of age or older, and over half of them were male. Therefore, the results of this study may not accurately reflect the effects of self-confidence in younger adults. Unfamiliarity with wheeling was not a concern, as all participants had at least six months of daily experience using a manual chair prior to participating in this study. Each participant took part in a wheelchair skills evaluation and completed a questionnaire about confidence in performing various wheelchair skills, among other SCI-related information.

What does this mean for people with SCI?

Older wheelchair users are more likely to participate in activities if they feel more confident with their manual chair. Making an effort to increase self-confidence should increase the likelihood of taking part in new and interesting activities, and increase the chance for successful participation.

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