Pediatric powered mobility training: powered wheelchair versus simulator-based practice

Many children with physical disabilities lack independent mobility. Powered mobility can be a viable option, but to become proficient drivers, children need opportunities to practice. As is often the case, practice powered wheelchairs are scarce and direct therapy hours dedicated to powered mobility are often limited. Hence, alternative options are needed to enable safe, unsupervised practice. Simulator-based learning has been shown to be an effective training method for powered mobility and other skill-based tasks for adults. The goal of this study was to compare two training methods of powered mobility, powered wheelchair (control group) versus simulator-based (experimental group) practice to determine whether simulation is a feasible and effective method for youth. Method: Participants included 30 children and adolescents (23 males, 13 females) with cerebral palsy and other neuromuscular diseases, aged 6–18. Data were collected and compared at baseline and after 12 weeks of home-based practice via a powered wheelchair or a simulator. Powered mobility ability was determined by the Powered Mobility Program (PMP), the Israel Ministry of Health’s Powered Mobility Proficiency Test (PM-PT) and the Assessment of Learning Powered Mobility (ALP). Results: All participants practiced for the required amount of time and both groups reported a similar user experience. Both groups achieved significant improvement following the practice period as assessed by the PMP and PM-PT assessments, with no significant differences between them. A significant improvement was found in the ALP assessment outcomes for the powered wheelchair group only. Conclusions: This is the first study, to our knowledge, that compares two different wheelchair training methods. Simulator-based practice is an effective training option for powered mobility for children with physical disabilities aged 6–18 years old, demonstrating that it is possible to provide driving skill practice opportunities safe, controlled environments.