# Awareness, utilization, and implementation barriers of the wheelchair skills program and test in Korea: a survey of users and clinicians

## TL;DR

This study finds that wheelchair skill training programs are poorly known and used in Korea, with gaps between what clinicians teach and what users need, and suggests digital solutions and policy changes to improve access.

## Contribution

The study identifies specific implementation barriers and user preferences for wheelchair skill training in Korea, offering insights for program development.

## Key findings

- Awareness of WSP and WST is critically low among both users and clinicians in Korea.
- There is a mismatch between the skills taught by clinicians and those used by wheelchair users in daily life.
- Digital delivery and policy support are seen as key to improving wheelchair skill training in Korea.

## Abstract

The Wheelchair Skills Program (WSP) and Wheelchair Skills Test (WST) have been widely validated and implemented in Western rehabilitation settings. However, although the WSP and WST have been introduced in Korea, the extent of their awareness and use remains unclear. In addition, their clinical- and community-level integration has not yet been systematically evaluated.

To investigate the awareness, utilization, and perceived necessity of WSP and WST among wheelchair users and clinical professionals in Korea, and to identify barriers to implementation and preferences for future program development.

A nationwide cross-sectional survey was conducted between August 2023 and July 2024. A total of 134 wheelchair users and 120 clinical professionals (physical therapists) participated. Validated questionnaires assessed demographics, wheelchair skill usage and training experience, awareness of WSP/WST, and preferences for program formats.

Awareness of WSP and WST was critically low in both groups: 98.3% of clinicians and 82.1% of users reported no knowledge of related training manuals or tools. Only 5.0% of clinicians had ever used training or assessment materials. Among clinicians, the most frequently taught skills were transfer (65%), body lift (48.3%), and forward propulsion (35%). In contrast, users most frequently performed forward propulsion (47.8%), reverse propulsion (34.3%), and turning (30.6%), highlighting a mismatch between instruction and real-world demands. Over 70% of respondents in both groups agreed that a Korean-style wheelchair skills program would be useful (71.7% of clinicians; 89.6% of users). Preferred formats differed: 56.7% of clinicians favored mobile/online delivery, while users expressed similar interest in both mobile platforms (38.3%) and in-person training by professionals (35.8%). Barriers to implementation included high patient loads (47.8% treating over 20 patients daily) and a national shortage of physical therapists (0.84 per 1,000 population, below the OECD average of 1.09).

Despite the introduction of K-WSP, awareness and utilization of wheelchair skill training programs remain extremely limited in Korea. There are clear gaps between clinical practice and user needs, as well as structural barriers such as workforce limitations and lack of institutional support. To address these issues, national strategies must promote curricular integration, continuing education, policy-level support, and digital platform development to enable scalable wheelchair skill education.