Mild Cognitive Impairment Clinical Trial
Official title:
Collaborative Power Mobility Innovative Learning OpporTunity (CoPILOT) - A Pilot Study of a New Training Approach (Phase 2)
Losing the ability to walk can lead to fewer opportunities to socialize with friends and family and participate in the community. When this happens, powered wheelchairs can provide access to homes and communities, contributing to health and well-being. Training by a qualified occupational therapist allows an individual to use a powered wheelchair safely and effectively. Learning to drive a powered wheelchair can be difficult, frustrating and time consuming for people with cognitive and physical challenges. In this study, the investigators will ask participants with cognitive impairments to complete training with an occupational therapist using either a shared control wheelchair or training methods according to the standard of care. The investigators believe shared control training, entitled Collaborative Powered mobility Innovative Learning OpporTunity (CoPILOT) will enhance driving skill while maximizing safety learning. CoPILOT has the potential to enable people to participate more in their day to day lives and regain mobility independence.
Background: Powered wheelchairs can improve participation in daily life, increase quality of
life, and add 'life to years' for individuals with SCI. Cognitive limitations, associated
with advanced age at the time of a spinal cord injury or comorbid traumatic brain injury,
impair learning and may prevent an individual from acquiring or maintaining skills necessary
to drive a powered mobility device. Standard power wheelchair training, limited by time,
equipment and budget constraints, may not meet the learning needs of individuals with
cognitive impairment, preventing an individual from obtaining use of a powered wheelchair,
impacting independence and quality of life. The total system cost of procuring a power
wheelchair can range from $10,000 - $30,000; suboptimal use resulting from inadequate
training is a poor use of resources and comes at a substantial social price. The
Collaborative Power mobility Innovative Learning OpporTunity (CoPILOT) is a training approach
utilizing shared control wheelchair technology and allows a therapist to provide an
error-free learning experience for individuals in their own environments, while maintaining
safety of the user and the individuals around them. Using shared control technology, the
wheelchair user remains in control of the wheelchair while learning to drive, except in cases
where the trainer overrides the control (using a remote controlled interface) to maintain
safety and provide targeted learning opportunities.
Purpose and Objectives: The purpose of this study is to obtain pilot data for a larger
randomized control trial of a shared control power wheelchair training program (CoPILOT) for
improving power wheelchair mobility skills among novice power wheelchair users with comorbid
cognitive impairment compared to standard of care. Collection of pilot data is necessary
prior to moving forward with a larger randomized controlled trial (RCT).
Hypotheses: The investigators expect the intervention protocol will be feasible for a larger
randomized control trial. Compared to the standard of care group, the investigators expect
the CoPILOT group will experience significant improvement in power wheelchair skill capacity.
The investigators also expect the CoPILOT group will experience improvements in wheelchair
skill safety, confidence, capacity for divided attention tasks, and health related quality of
life, compared to the standard of care participants.
Methods: This feasibility study will use an evaluator blind parallel RCT. New power
wheelchair users with mild to moderate cognitive impairment will be recruited from the GF
Strong or Vancouver General Hospital Spinal Cord Injury patient population. Participants will
be randomly assigned to a CoPILOT (shared control training) group or standard of care group.
All training will be completed by qualified occupational therapist trainers. Participants in
both groups will receive either 6 or 12 hours of training in a standard powered wheelchair;
however, the CoPILOT groups will use remote control technology the investigators have
developed. Post-Treatment Qualitative Interviews will be conducted. Questions will be related
to protocol administration and use of the CoPILOT approach and shared control technology,
including necessary modifications.
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