Skills on Wheels: Development and Benefits of an Upper Extremity Home Exercise Program

Abstract

Participants of the Skills on Wheels Program are manual wheelchair users who are part of pediatric population and have underlying diagnoses that has impacted their functional mobility skills, such as manual wheelchair propulsion. In some cases, this has impacted their overall upper extremity functioning as well. To have adequate manual wheelchair skills, it is essential to have strong upper extremity functioning. Research suggests that providing upper extremity home exercise programs (HEPs) can have a positive impact manual wheelchair users’ upper extremity functioning, such as their range of motion (ROM) and hand strength. Other studies have suggested that manual wheelchair users will experience chronic pain from overuse injuries due to consistent manual wheelchair propulsion in their everyday life. The purpose of this doctoral capstone project was to determine the effectiveness of implementing a client centered upper extremity HEP to the Skills on Wheels program. The capstone student prepared for this by gaining clinical practice skills in the relevant focus area and conducting literature reviews. With the skills gained through preparation, the capstone student created an upper extremity HEP that was client friendly and specific. Participants of Skills on Wheels were provided with either a client centered HEP, a general HEP, or no exercises. Various outcomes were identified by the student with this implementation of an upper extremity HEP. The results suggested that although there are benefits to implementing an upper extremity HEP, there may also be implications of overuse of the upper extremity that is decreasing the participants’ overall upper extremity functioning.