Manual wheelchair training for people with chronic and progressive conditions: priority recommendations for a qualitative multi-method study

Purpose Manual wheelchair training is essential for safe and independent wheelchair use; however, provision remains inconsistent and lacks alignment with the needs of people who commence wheelchair use later in life secondary to a chronic or progressive condition. Existing recommendations call for coordinated service delivery, clearer accountability and safe, contextually relevant training, but offer limited guidance on how recommendations should be prioritised or implemented. This study aimed to prioritise recommendations and provide practical guidance for manual wheelchair training for people with chronic and progressive conditions.Materials and Methods A two-phase qualitative synthesis was employed. Phase one involved an online consultation with manual wheelchair users and trainers using a modified Nominal Group Technique, followed by content analysis. Phase two used thematic network analysis to synthesise these findings with existing recommendations to refine guidance for manual wheelchair training.Results Phase one prioritised key manual wheelchair training recommendations and generated practice-relevant categories. Phase two refined these into four overarching themes; 1. Building system capacity and equitable access to MWC training, 2. Governance, accountability and quality assurance across the training continuum, 3. Person centred, safe and meaningful MWC training and 4. Foundations for high quality and inclusive training.Conclusion Improving manual wheelchair training for older adults with chronic and progressive conditions requires coordinated system reform. Aligned funding, governance and accountability must support outcome frameworks prioritising user-valued outcomes and a workforce capable of delivering training across contexts and time. These findings provide actionable recommendations to improve equity, safety and continuity of manual wheelchair training.