The assistive technology program at the Rehabilitation Centre for Children, housed at Specialized Services for Children and Youth in Winnipeg, has not had a formal wheelchair skills training program in place until now.

Second-year OT students Keerthana Kalliat and Lexie Rea developed the day camp, dubbed “Wicked Wheels,” as part of their final advanced fieldwork placement before graduating this fall.

Kalliat, who has a previous degree in rehabilitation science and technology from the University of Pittsburgh, said the camp allows kids a chance to get to know their wheelchairs in a safe and controlled environment. 

“Usually when kids are prescribed wheelchairs, they may receive some basic training on how to use it, but more advanced skills such as getting up a ramp or getting over obstacles are harder to teach during wheelchair appointments. The kids usually must figure this out themselves over time,” she says.

The program was divided into two two-week blocks, where children aged five to 11 would attend day camps at RCC twice a week, led by Kalliat, Rea and two teenage mentors who are also wheelchair users.

The camps included games and activities, including obstacle courses, that would incorporate the skills they learned in fun ways.

“We ended a lot of our sessions with a game of tag, which the kids loved playing,” said Rea, who has a bachelor of health sciences from UM.

“It’s a fun way to use some of the skills they’ve been working on – whether that is propelling their wheelchairs forward, backward or stopping on command. If another kid is coming to tag them, they need to stop and turn quickly.”

(L-R) Keerthana Kalliat and Lexie Rea

Dena Stitz, a senior occupational therapist at RCC, said the program is something she was interested in starting since she started at the centre five years ago.

“We’ve been able to fit wheelchairs and teach kids some basic things, but these kids are all getting eight hours of intensive wheelchair training, which is something we didn’t have time to facilitate,” she said.

Stitz, a UM occupational therapy graduate from 2018, contacted one of her former professors, Dr. Ed Giesbrecht, about six months ago to get the project started.

“This is really quite cutting edge,” Giesbrecht said. “There are a couple of university hospitals in the U.S., some work in Belgium and the Netherlands and a program going on in Quebec City, but that’s really about it in terms of using camps to teach skills to kids.”

As the students wrap up their placement, they are preparing a proposal for RRC to use the program going forward.

Stitz said she’s excited to have the program continue.

“Watching the camps has been amazing. The kids are happy, the caregivers are happy. The skills they are learning are crucial, but the sense of community has been amazing to see,” she said.

Kalliat and Rea both said the sense of community between the kids and the peer mentors was one of the highlights of the program. They said the other big takeaway was the confidence the kids were building in their wheelchair skills.

“A lot of times they were hesitant in the beginning, and by the end they wanted to be the ones to demonstrate those skills,” said Rea. “They were really proud of what they could do, and that was cool to see.”

The College of Rehabilitation Sciences, Rady Faculty of Health Sciences, hosted five members of the AUAS Faculty of Health on November 18 – 22. The visit included working sessions and discussions on three themes they plan to collaborate on: inter-professional education (IPE) research, working in and with communities and digital health technologies.

The universities were awarded a grant in June from the EU-funded Erasmus program to sponsor five lecturer/researchers from each facility to visit the other over the next two years. As part of the funding, representatives from the College of Rehabilitation Sciences will visit AUAS in 2020.

“We aim to bring new knowledge to our students, faculty and clinical community by promoting exchanges, collaborative research and new forms of outreach,” said Dr. Reg Urbanowski, dean, College of Rehabilitation Sciences, Rady Faculty of Health Sciences.

Dr. Margo van Hartingsveldt, head of the AUAS school of occupational therapy.

During the visit, AUAS dean Dr. Wilma Scholte op Reimer and Dr. Brian Postl, dean, Rady Faculty of Health Sciences and vice-provost (Health Sciences), signed a declaration of intent to collaborate and advance shared education.

Among the highlights were a day trip to Lake Manitoba First Nation, where the college is involved in several initiatives through its Kiga mamo anokimin onji minoayawin project, and a visit to the Northern Connection Medical Centre, a Winnipeg-based primary care clinic that treats individuals from northern communities.

Dr. Margo van Hartingsveldt, head of the AUAS school of occupational therapy, said the visit to Lake Manitoba First Nation showed similarities between the universities’ involvement in community partnerships.

“The aim in both countries is setting up projects for students to learn and recognize the enormous benefits they can gain from engaging in research or education in the community,” she said. “For the U of M these projects are located in First Nation communities and for us, in the city of Amsterdam, in neighborhoods with many citizens with a low social economic position and a migration background.”

The college also hosted a series of Illuminate speaker sessions, where faculty members from both universities shared overviews of their research with each other and rehabilitation sciences students.

AUAS professor Bart Visser.

One of the sessions focused on digital health technology and featured AUAS professor Bart Visser, along with U of M occupational therapy associate professors Dr. Jacquie Ripat, Dr. Amine Choukou and Dr. Ed Giesbrecht. The session focused on mobile health applications for older adults and people in wheelchairs and the use of technology such as sensors and remote monitoring systems in health-care practice, areas of research that are growing for both faculties.

Visser said he found the similarities to the universities’ approach to digital health “striking,” including mobile health applications aimed at behavioral change that have been developed. He said there is great potential to work together in this area in the future.

“It is a necessity to broaden the collaboration with computer sciences and engineering at both universities to make digital health a success,” he said.

Urbanowski said the universities are finalizing details of faculty and student exchange agreements and developing an agreement on a joint research fund. 

Second-year students CindyMarie Mack, Jason Robillon and Nikita Carreiro completed what they believe to be the first study evaluating occupational therapy students’ confidence to assess an individual’s wheelchair skills as well as teach them new skills to apply in clinical practice.

The goal of the Independent Study was to gauge the impact of the boot camp in the short and longer term. The four-hour ‘boot camp’ has been run as part of the MOT curriculum for several years by Dr. Ed Giesbrecht, Associate Professor, College of Rehabilitation Sciences, Rady Faculty of Health Sciences.

“Occupational therapists are the clinicians that typically teach wheelchair skills to the individuals who are newly prescribed a wheelchair,” said Mack. “So we’re the ones who need to know the skills to transfer them along. An individual’s ability in their wheelchair affects their participation and quality of life. The better their skills, the better their quality of life.”

Three quantitative measures were used to assess perceived manual wheelchair (MWC) skill capacity, confidence in manual wheelchair skills and confidence in assessing, training, spotting, and documenting manual wheelchair skills.

Forty-two boot camp attendees filled out self-reporting questionnaires before and immediately after the session and then four months later. The four-month follow-up was aimed at demonstrating how well students retained what they took away from the hands-on boot camp.

The study found that students’ confidence and skills significantly increased, statistically, across all measures, and gains were retained in all but one measure, that of perceived MWC capacity. Qualitative results collected at the four-month follow-up also revealed an increase in students’ empathy towards wheelchair users – despite the fact that the boot camp did not directly address empathy.

Some participating students thought there wasn’t enough time in the boot camp to master the higher level wheelchair skills taught to them. Others suggested that skill retention could increase with a shorter secondary boot camp or more opportunities to practice the skills developed in the primary boot camp.

Previous studies have looked at what education wheelchair skills users are receiving and showed that education across Canada is varied.

“We hope that people will see our results and understand the effectiveness of boot camps like this. Maybe other occupational therapy programs or even practicing clinicians will see the benefits and seek training like this at school or as professional development,” said Robillon

The boot camp has been at times an optional component of the College’s MOT program, but Mack, Robillon and Carreiro believe their results prove how important and effective it is in preparing occupational therapy students to work with wheelchair patients in the future.

That experience in clinical work was the impetus that sparked Giesbrecht’s research on mobility issues. Now, as a researcher and assistant professor in the department of occupational therapy in the College of Rehabilitation Sciences (CoRS), he is able to focus his work on enabling people to do the things that are important to them.

“My specific research is around people who use wheelchairs and other mobility aids,” he says. “My work looks at the various aspects of how to improve participation for those people, whether it’s the kind of equipment they use; accessibility in the environment; or looking at how we can provide better skills to use the equipment they already have.”

Giesbrecht is currently involved in a series of projects that provide better skills to people to be able to use their wheelchairs more effectively.

“As simple as it might look, using a wheelchair and overcoming barriers that exist can be quite challenging,” Giesbrecht says. “We have looked at different ways that we can provide training to people to improve their use of their wheelchairs. For my doctoral dissertation we developed a home training program that could be delivered using a computer tablet and people could learn skills and practice in their chairs so they’re better able to engage in their environment.”

Giesbrecht is also looking forward to working with (CoRS) research lead Dr. Jacquie Ripat on a project focusing on the unique challenges brought about by Manitoba’s snowy climate.

“We’re hoping to create an obstacle course that we can use for the evaluation of equipment and training people on how to use their wheelchair in winter and looking at the winter-specific challenges for people using mobility devices,” he says.

Working on these research projects, Giesbrecht derives satisfaction from the people he interacts with.

“When we do studies and he hear from the participants about how this has improved their lives and changed their ability to do what they want to do, that’s always an incredible reinforcement for continuing in this area of research,” he says. “Our calling is to look after each other as a community and we need to work collaboratively to ensure our communities support each other. I think that’s what health care delivery and research is all about, to ensure that we all have access and all can be part of the community.”