| Sumario: | Background: Manual wheelchairs (MWCs) are essential for individuals with mobility impairments, yet many users receive limited training, restricting mobility and participation. Innovative alternatives to therapist-led approaches, including eHealth and peer-led interventions, are emerging to address this gap. Purpose: This follow-up study examined long-term retention of participation and related outcomes 6 months after an eHealth wheelchair skills training program. Secondary aims explored associations between participant demographics, program engagement and post-intervention outcomes. Methods: A repeated-measures cohort design was used with intervention participants from a multi-site randomised trial conducted across three Canadian urban centres. Nineteen adults using MWCs completed the 4-week TEAM Wheels program, comprising a tablet-based app with 200+ instructional videos and three peer-led teleconferences. Outcomes included participation, wheelchair skills capacity and performance, self-efficacy and health-related quality of life (HRQoL). Findings: At 6 months, participants (n = 18) maintained or improved statistically significant gains in participation, skills and self-efficacy but not HRQoL. Improvements were comparable across demographic groups, whereas meeting recommended engagement guidelines was linked to larger gains in skills and confidence. Conclusion: TEAM Wheels benefits were largely retained at 6 months. eHealth and peer-led approaches offer promising, sustainable alternatives to traditional clinician-led MWC skills training. Clinical Trial Registration No. NCT04090177 IMPLICATIONS FOR REHABILITATION: Peer-led, eHealth-based wheelchair skills training is a promising alternative to traditional therapist-led training, supporting improved participation, skills and confidence among manual wheelchair users. Findings demonstrate sustained improvements in participation, wheelchair skills capacity and self-efficacy 6-months after intervention, highlighting the potential long-term benefits of integrating eHealth and peer-led approaches into rehabilitation. Greater engagement with eHealth program was associated with larger improvements, underscoring the importance of participant adherence to training guidelines.
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