<p>Using a cross-sectional design, Bandura's (1986) Social Cognitive Theory and Self-Efficacy Theory (1977) were used as a framework to determine whether wheelchairuse self-efficacy and exercise barrier self-efficacy mediate the relationship between wheelchair mobility and leisure-time physical activity (LTPA) in people with spinal cord injury (SCI). Fourty-six manual wheelchair users (76.1 % male), with varying levels of SCI (80.4% paraplegic, 47.8% complete injuries) participated in this study. Participants completed The Wheelchair Skills Test version 4.1 (Wheelchair Skills Test Version 4.1 [WST 4.1],2008) which measured wheelchair mobility, a modified barrier self-efficacy questionnaire (McAuley & Mihalko, 1998) which measured exercise barrier self-efficacy, the Wheelchair Mobility Confidence Scale (WMCS; Rushton & Miller, 2009) which measured wheelchair-use self-efficacy, and the Physical Activity Recall Assessment for people with SCI (PARA-SCI; Martin Ginis, Latimer, Hicks & Craven, 2005) which measured LTPA. It was hypothesized that (1) there would be a positive relationship between wheelchair mobility and LTPA, and (2) wheelchair-use self-efficacy and exercise barrier self-efficacy would mediate this relationship. Using linear regression models, a positive association between wheelchair mobility and LTPA was established (β = .29, p < .05). Exercise barrier self-efficacy was a significant partial mediator, explaining 47.7% ofthe variance in the mobility-LTPA relationship. Wheelchair-use selfefficacy was a non-significant mediator. This thesis has practical and theoretical implications for understanding and improving LTPA participation and represents the first study to determine the relationship between wheelchair mobility, self-efficacy, and LTPA in people living with SCI.</p> / Master of Science (MS)

Introduction : Une utilisation non-optimale du fauteuil roulant manuel (FRM) peut avoir des répercussions sur différents aspects de la vie des enfants et jeunes qui utilisent cette aide à la mobilité. Malgré la disponibilité et l'efficacité du Wheelchair Skills Program (WSP), l'entraînement des habiletés en FRM est parfois inadéquat ou absent en pratique. Pour combler cette lacune entre les connaissances et la pratique, ce mémoire vise à identifier les besoins et les enjeux concernant l’évaluation et l’entraînement des habiletés en FRM en réadaptation pédiatrique. Méthodes: Guidé par le cadre Knowledge to Action, une étude à devis mixte séquentiel explicatif a été conduite dans un centre de réadaptation pédiatrique et ses écoles affiliées. La phase quantitative comprenait une enquête en ligne auprès d'ergothérapeutes et un questionnaire papier auprès d’usagers pédiatriques et de leurs parents. La phase qualitative comprenait des groupes de discussion avec les ergothérapeutes. L’analyse a utilisé des statistiques descriptives et une méthode déductive basée sur le Consolidated Framework for Implementation Research. Résultats : Les résultats du sondage aux ergothérapeutes (n=35) montrent une divergence entre l’importance perçue à l’égard de l’évaluation et l’entraînement des habiletés en FRM (94% jugent important) et leur prévalence dans la pratique. Peu d’ergothérapeutes utilisent des outils standardisés et forment principalement les enfants aux habiletés de base (c.-à.-d., d’intérieur) et les parents à l'entretien du FRM. Les réponses du questionnaire aux usagers corroborent ces résultats alors que les enfants et parents décrivent des difficultés à l’utilisation du FRM dans la communauté, en plus de rapporter des chutes. Les résultats des groupes de discussion révèlent des barrières à l’utilisation du WSP qui expliquent les lacunes observées dans la pratique. Conclusion : Pour surmonter les barrières à l’utilisation du WSP en réadaptation pédiatrique, des adaptations au WSP et la production d'outils pour le transfert de connaissances (TC) ont été proposées avec la création de nouvelles connaissances par la recherche. / Introduction : Suboptimal manual wheelchair use can have repercussions on different aspects of the lives of children and adolescents who use this mobility aid. Despite the availability and effectiveness of the Wheelchair Skill Program (WSP), manual wheelchair skills training is often inadequate or absent in clinical practice among occupational therapists (OTs). To bridge this evidence-practice gap, this thesis aims to identify and understand the needs and challenges regarding manual wheelchair skills testing and training practices in pediatric rehabilitation. Methods: Guided by the Knowledge to Action Framework, an explanatory sequential mixed methods design was employed. The quantitative phase involved an online survey with OTs working in a pediatric rehabilitation center and its affiliated schools and a paper survey with pediatric manual wheelchair users and their parents. The qualitative phase involved focus groups with the OTs. Data were analyzed using descriptive statistics and a deductive analysis based on the Consolidated Framework for Implementation Research. Results: According to the OT survey results (n=35), there is a discrepancy between the perceived importance of wheelchair skills testing and training (94% consider it important) and their prevalence in practice. Of the training provided, children are primarily trained indoor skills, while parents are primarily educated about wheelchair maintenance. Standardized, evidence-based tools are rarely used. The child survey results corroborate these findings as the children and parent described difficulties with many community and advanced wheelchair skills, as well as falls experienced in these situations. The focus group findings identified barriers to using the WSP which explained the gaps observed in practice. Conclusion: To address the identified barriers, recommendations of WSP adaptations and knowledge translation (KT) tools production were proposed with creation of new knowledge. Findings from this thesis establish a first step towards bridging the evidence-practice gap in manual wheelchair skills testing and training.