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Yang P, Ma M, Guan Q, Du X, Fan Y. Assessing the needs of informal caregivers of patients with chronic non-communicable diseases: A systematic review of self-assessment tools. Nurs Open 2023; 10:7467-7486. [PMID: 37789573 PMCID: PMC10643841 DOI: 10.1002/nop2.2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 05/25/2023] [Accepted: 09/17/2023] [Indexed: 10/05/2023] Open
Abstract
AIM To synthesize self-administrated needs assessment tools of informal caregivers for patients with chronic non-communicable diseases (CNCDs), evaluate the quality of psychometric properties and identify main needs assessment themes. DESIGN Systematic review. METHODS Eight electronic databases both in English and Chinese were searched for. The psychometric properties of tools were evaluated according to the quality criteria for good psychometric properties developed by Terwee et al. Both the content analysis and thematic extraction methods were used. Needs assessment themes were categorized based on the 7-level Maslow's Hierarchy of Needs Theory. RESULTS A total of 17 tools were synthesized. Thirteen of them targeted informal caregivers of patients with cancer. The psychometric properties evaluated for most of these tools were content validity, internal consistency and construct validity. A total of 27 needs themes were identified and matched to six levels based on the 7-level Maslow's Hierarchy of Needs theory, besides the aesthetic needs level. NO PATIENT OR PUBLIC CONTRIBUTION No primary data are being collected.
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Affiliation(s)
- Panpan Yang
- School of NursingBinzhou Medical UniversityYantaiShandongChina
| | - Mengzhen Ma
- School of NursingBinzhou Medical UniversityYantaiShandongChina
| | - Qingyi Guan
- School of NursingBinzhou Medical UniversityYantaiShandongChina
| | - Xingbin Du
- School of NursingBinzhou Medical UniversityYantaiShandongChina
| | - Yanyan Fan
- School of NursingBinzhou Medical UniversityYantaiShandongChina
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Campos LCB, Caro CC, Fachin-Martins E, Cruz DMCD. Cross-cultural adaptation and reliability of the Brazilian version of the wheelchair skills test-questionnaire 4.3 for manual wheelchair users. Assist Technol 2022; 34:54-60. [PMID: 31769738 DOI: 10.1080/10400435.2019.1697906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The Wheelchair Skills Test-Questionnaire form for Manual Wheelchairs Operated by Wheelchair Users (WSTQ-M-WCU 4.3) assesses wheelchair skills that may influence users' occupational performance in their daily activities. The purpose of this study was to cross-culturally adapt the WSTQ-M-WCU 4.3 to Brazilian Portuguese and to examine the inter-rater and test-retest reliabilities. This is a methodological study of cross-cultural adaptation and psychometric properties of reliability. The agreement achieved in the cross-cultural adaptation concerning idiomatic, cultural, conceptual and semantic aspects was 100%, 99.2%, 100% and 96.18%, respectively. We analyzed the test-retest and inter-rater reliabilities in a convenience sample of 46 manual wheelchair users using Cronbach's Alpha and Bland-Altman plots. The Brazilian version has excellent internal consistency (α > 0.9) and strong inter-rater reliability (p < .05). This instrument can guide practitioners in training wheelchair skills, thus contributing to the planning of interventions and for evidence-based practice in Assistive Technology.
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Affiliation(s)
| | - Camila Caminha Caro
- Department of Occupational Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
| | - Emerson Fachin-Martins
- Program in Science of Rehabilitation, Universidade de Brasília, Distrito Federal, Brazil
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Worobey LA, Hibbs R, Rigot SK, Boninger ML, Huzinec R, Sung JH, Rice LA. Intra- and Interrater Reliability of Remote Assessment of Transfers by Wheelchair Users Using the Transfer Assessment Instrument (Version 4.0). Arch Phys Med Rehabil 2021; 103:816-821. [PMID: 33711281 DOI: 10.1016/j.apmr.2020.12.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/15/2020] [Accepted: 12/19/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the reliability, standard error of measurement, minimum detectable change, and item-level consistency of the Transfer Assessment Instrument (TAI) version 4.0 when used to evaluate transfer quality remotely. DESIGN Participants transferred from their wheelchair to a mat table (transfer 1), repeated this after a 10-minute delay to assess intrarater reliability (transfer 2), and repeated this 1-2 days later to assess test-retest reliability (transfer 3). Each transfer was scored in person by 4 raters and asynchronously by a remote clinician rater. SETTING 2017 National Veterans Wheelchair Games. PARTICIPANTS Convenience sample of 44 full-time wheelchair users (N=44). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES TAI total score, subscores (wheelchair setup, body setup, flight/landing), and item scores (15 items). RESULTS Moderate to excellent reliability was found when scoring remotely for TAI total and subscores for intrarater (intraclass correlation coefficient (ICC(3,1)=0.687-0.854), test-retest (ICC(3,1)=0.695-0.836), and interrater reliability (ICC(3,5)=0.746-0.962). Remote rater total score and flight/landing subscore were greater (indicating higher transfer quality) compared to the average in-person raters (P=.021 and P=.005, respectively). There were no differences between transfers 1-3 in remote rater scores. Item-level percentage agreement between the remote rater and in-person exceeded the 75% cutoff for clinical utility for all items. CONCLUSIONS The TAI is a reliable outcome measure for assessing transfer technique remotely.
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Affiliation(s)
- Lynn A Worobey
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Departments of Physical Medicine and Rehabilitation; Bioengineering; Physical Therapy; University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA.
| | - Rachel Hibbs
- Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA
| | - Stephanie K Rigot
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Bioengineering; University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA
| | - Michael L Boninger
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Departments of Physical Medicine and Rehabilitation; Bioengineering; Physical Therapy
| | - Randall Huzinec
- University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA
| | - Jong H Sung
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
| | - Laura A Rice
- Department of Human Performance and Sport Studies, Idaho State University, Pocatello, ID
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Worobey LA, Rigot SK, Boninger ML, Huzinec R, Sung JH, DiGiovine K, Rice LA. Concurrent Validity and Reliability of the Transfer Assessment Instrument Questionnaire as a Self-Assessment Measure. Arch Rehabil Res Clin Transl 2021; 2:100088. [PMID: 33543111 PMCID: PMC7853356 DOI: 10.1016/j.arrct.2020.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives To evaluate the psychometric properties of the Transfer Assessment Instrument Questionnaire (TAI-Q), a self-assessment measure to evaluate transfer quality compared with clinician-reported measures. Design Participants self-assessed transfers from their wheelchair to a mat table using the TAI-Q. For session 1, participants self-assessed their transfer both before and after reviewing a video of themselves completing the transfer (session 1). Self-assessment was completed for another transfer after a 10-minute delay (session 2, intrarater reliability) and after a 1- to 2-day delay (session 3, test-retest reliability). Self-assessment was compared with a criterion standard of an experienced clinician scoring the same transfers with the Transfer Assessment Instrument (TAI) version 4.0 (concurrent validity). Setting 2017 National Veterans Wheelchair Games. Participants Convenience sample of full-time wheelchair users (N=44). Interventions Not applicable. Main Outcome Measures TAI-Q and TAI. Results After video review of their transfer, acceptable levels of reliability were demonstrated for total TAI-Q score for intrarater (intraclass correlation [ICC], 0.627) and test-retest reliability (ICC, 0.705). Moderate to acceptable concurrent validity was demonstrated with the TAI (ICC, 0.554-0.740). Participants tended to underestimate the quality of their transfer (reported more deficient items) compared with the TAI. However, this deficit decreased and reliability improved from pre-video review to post-video review and from session 1 to session 2. The minimum detectable change indicated that a change of 1.63 to 2.21 in the TAI-Q total score is needed to detect a significant difference in transfer skills. Conclusions When paired with video review, the TAI-Q demonstrates moderate to acceptable levels of reliability and validity for the total score. Self-assessment was completed quickly (<5min) and could help to potentially screen for deficiencies in transfer quality and opportunities for intervention.
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Affiliation(s)
- Lynn A Worobey
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.,Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.,University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA
| | - Stephanie K Rigot
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
| | - Michael L Boninger
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
| | - Randall Huzinec
- University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA
| | - Jong H Sung
- Department of Human Performance and Sport Studies, Idaho State University, Pocatello, ID
| | - Kaitlin DiGiovine
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL
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Mortenson WB, Battalova A, Hurd L, Hobson S, Emery R, Kirby RL. Correlates of self-reported Wheelchair Skills Test Questionnaire scores of new users of mobility scooters: a cross-sectional study. Disabil Rehabil Assist Technol 2021:1-8. [PMID: 33503387 DOI: 10.1080/17483107.2021.1874065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To describe the subjective reported scooter-skill scores of new mobility scooter users and to identify significant correlations with other characteristics and measures. MATERIALS AND METHODS This was a single-centre study using a cross-sectional design. Participants (N = 22) completed the Wheelchair Skills Test-Questionnaire (WST-Q) Version 4.3 for scooter users. It measures the users' perceived capacity (what the user can do), performance (what the user actually does), and confidence (or self-efficacy). Their scooter skills were also rated objectively with the Wheelchair Skills Test (WST). They completed standardised measures of cognition, hearing, vision, life space mobility, visual attention and task switching, and confidence negotiating the social environment using their scooters. RESULTS Mean total WST-Q capacity scores were 83% and performance scores were 25%. WST-Q capacity scores had significant positive correlations with WST-Q performance (r = 0.321) and confidence scores (r = 0.787), WST capacity scores (r = 0.488), and confidence negotiating the social environment (WheelCon) (r = 0.463). WST-Q capacity scores were significantly negatively correlated with Trail Making B scores (r = -0.591) and age (r = -0.531). CONCLUSIONS The correlations between WST-Q scores and other variables are similar to those found in other studies among users of scooters and other mobility devices. The gap between capacity and performance scores highlights the needs for additional skills training in this population of novice scooter users.IMPLICATIONS FOR REHABILITATIONIn implementing scooter training for new scooter users, attention should be paid to building community-based skills for navigating both the physical and the social environment.Scooter users' age and their driving capabilities need to be taken into account when developing and delivering the training.
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Affiliation(s)
- W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Alfiya Battalova
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Laura Hurd
- School of Kinesiology, University of British Columbia, Vancouver, Canada
| | - Sandra Hobson
- School of Occupational Therapy, University of Western Ontario, London, Canada
| | - Richelle Emery
- Vancouver Coastal Health - Community Care, Vancouver, Canada
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Canada
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Barbareschi G, Sonenblum S, Holloway C, Sprigle S. Does the setting matter? Observing wheelchair transfers across different environmental conditions. Assist Technol 2020; 34:326-333. [PMID: 32897816 DOI: 10.1080/10400435.2020.1818328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The setting in which wheelchair transfers are performed can affect the difficulty and the risks associated with completion. This article presents results from an observational study involving 13 wheelchair users performing independent transfers across four settings. The aim is to understand how the environment affects how different types of independent transfers are performed. Descriptive analysis was performed alongside an objective assessment using the Transfer Assessment Instrument (TAI). The perceived difficulty reported after each transfer was also collected. Two participants exhibited radically different transferring techniques in different scenarios. Additionally, the transferring scenario was found to significantly affect the perceived difficulty of sitting transfers (toilet 2.17 ±.88; bed 1.47 ±.65, p =.001; car 1.63 ±.82, p =.012) and standing transfers (car 3.5 ±.71; bed 1 ± 0, p =.03; toilet 1 ± 0, p =.03), and the TAI score attributed to sitting pivot with use of a transfer board (couch 4.3 ±.88; bed 6.93 ± 1.29, p =.022; car 7.13 ± 1.32, p =.018). Overall, environmental constraints can lead to major technique changes and, more often, to different positioning of hands and feet which could impact the transfer's biomechanics.
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Affiliation(s)
| | - Sharon Sonenblum
- Rehabilitation Engineering and Applied Research, Georgia Institute of Technology, Atlanta, Georgia, USA
| | | | - Stephen Sprigle
- Rehabilitation Engineering and Applied Research, Georgia Institute of Technology, Atlanta, Georgia, USA
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Sindall P, Lenton JP, Mason BS, Tolfrey K, Cooper RA, Martin Ginis KA, Goosey-Tolfrey VL. Practice improves court mobility and self-efficacy in tennis-specific wheelchair propulsion. Disabil Rehabil Assist Technol 2020; 16:398-406. [PMID: 32412809 DOI: 10.1080/17483107.2020.1761892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Wheelchair tennis (WT) propulsion is uniquely characterized by the requirement for racket holding coupled with effective hand-rim contact. Thus, investigations involving strategies to enhance chair mobility skills are merited. The aim was to examine the effects of organized practice on WT match play responses and the impact of racket holding during practice. MATERIALS AND METHODS Following physiological profiling involving graded and peak exercise testing, 16 able-bodied (AB) participants performed bouts of WT match play interspersed with practice involving wheelchair mobility drills completed with (R) or without (NR) a tennis racket. A data logger recorded distance and speed. Self-efficacy was reported. RESULTS AND CONCLUSIONS Significant main effects for match revealed higher post-practice overall and forwards distances (p < 0.05), peak (p < 0.005) and average (p < 0.05) speeds and self-efficacy (SE) (p = 0.001) were attained. During practice, lower distances and speeds were achieved with R, with a lower physiological cost than NR. Practice increases court movement and SE with no associated increases in physiological cost. Changes represent enhanced court mobility. Differences between practice characteristics provide options for skill development and optimization of health outcomes.IMPLICATIONS FOR REHABILITATIONWheelchair tennis participation is likely to confer positive health effects in those with a disability or physical impairment.As chair propulsion combined with racket holding represents a complex skill challenge, novices may find the sport challenging to play.Tennis-specific mobility drills improve confidence and chair propulsion skill with likely crossover into tennis match play competence and ability.
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Affiliation(s)
- Paul Sindall
- School of Health and Society, The University of Salford, Salford, UK.,The Peter Harrison Centre for Disability Sport, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - John P Lenton
- The Peter Harrison Centre for Disability Sport, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Barry S Mason
- The Peter Harrison Centre for Disability Sport, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Keith Tolfrey
- The Peter Harrison Centre for Disability Sport, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Rory A Cooper
- Human Engineering Research Laboratories, Department of Veterans Affairs, Rehabilitation Research and Development Service, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology and Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kathleen A Martin Ginis
- School of Health and Exercise Sciences, The University of British Columbia, Vancouver, Canada
| | - Victoria L Goosey-Tolfrey
- The Peter Harrison Centre for Disability Sport, School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Vincent C, Gagnon DH, Dumont F. Pain, fatigue, function and participation among long-term manual wheelchair users partnered with a mobility service dog. Disabil Rehabil Assist Technol 2017; 14:99-108. [PMID: 29157032 DOI: 10.1080/17483107.2017.1401127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To assess the effects of a mobility service dog (MSD) on pain, fatigue, wheelchair-related functional tasks, participation and satisfaction among manual wheelchair users over a nine-month period. METHOD A longitudinal study with repeated assessment times before and three, six and nine months after intervention was achieved. Intervention consisted in partnering each participant with a MSD. The setting is a well-established provincial service dog training school and participants homes. A convenience sample of 24 long-term manual wheelchair users with a spinal cord injury was involved. Outcome measures were: Wheelchair User's Shoulder Pain Index (WUSPI), Rate of Perceived Exertion (RPE), vitality scale from the SF-36, grip strength, Wheelchair Skills Test (WST), Canadian Occupational Performance Measure (COPM), Reintegration to Normal Living Index (RNLI), Life Space Assessment, Psychosocial Impact of Assistive Devices Scale (PIADS) and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0). RESULTS Shoulder and wrist pain as well as fatigue decreased significantly over time with the use of a MSD as evidenced by scores from WUSPI, RPE and SF-36 (feeling less worn out). Manual wheelchair propulsion skills (steep slopes, soft surfaces and thresholds) improved significantly over time as confirmed by the WST. Participation increased significantly over time as revealed by the COPM (for five occupations) and the RNLI (for five items). Satisfaction with the MSD was high over time (QUEST: nine items) and with a high positive psychosocial impact (PIADS: 10 items). CONCLUSION MSD represents a valuable mobility assistive technology option for manual wheelchair users. IMPLICATIONS FOR REHABILITATION For manual wheelchair users partenered with mobility service dog • Shoulder pain and fatigue significantly decreased and continued to decrease between the third and sixth month and the ninth month. • Performance with propelling the wheelchair up steep slopes increased from 41 to 88% and on soft surfaces increased from 53 to 100% after 3 months, respectively. • Occupational performance satisfaction was significantly increased for mobility in relation with the transfers, navigating in a natural environment and picking up objects. • High satisfaction towards psychosocial competency, psychosocial adequacy and self-esteem were reported at months three, six and nine.
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Affiliation(s)
- Claude Vincent
- a Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSS de la Capitale Nationale de l' Institut de réadaptation en déficience physique de Québec , Quebec City , Canada.,b Department of Rehabilitation , Université Laval , Quebec City , Canada
| | - Dany H Gagnon
- c Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), CIUSSS Centre-Sud-de-l'île-de-Montréal, Institut de réadaptation Gingras-Lindsay-de-Montréal , Montreal , Canada.,d School of Rehabilitation , Université de Montréal , Montreal , Canada
| | - Frédéric Dumont
- a Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSS de la Capitale Nationale de l' Institut de réadaptation en déficience physique de Québec , Quebec City , Canada
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Mortenson WB, Hurd Clarke L, Goldsmith CH, Jang S, Kirby RL. Measurement properties of the Wheelchair Skills Test for scooters among experienced users. Disabil Rehabil Assist Technol 2017; 13:60-65. [PMID: 28164718 DOI: 10.1080/17483107.2017.1280546] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the score distribution, reliability, and validity of the objective Wheelchair Skills Test (WST) for scooter users. METHOD A study using a test-retest design was conducted with 20 people who had mobility limitations that prevented them from ambulating more than one city block without a mobility aid, and who had owned a scooter for ≥3 months. Objective scooter skills, confidence, and physical accessibility were measured at both time points, while anxiety, depression, visual attention and task switching, functional independence, and visual acuity were measured only at baseline. RESULTS The mean total WST scores at Time 1 and Time 2 were 86.3% and 87.5%. The WST ICC was 0.889. The WST had a SEM of 2.50 and a Cronbach's alpha of 0.74. The total WST scores were significantly correlated with total subjective WST-Q scores (r = 0.547, p = 0.013), scooter confidence (r = 0.466, p = 0.038), and were affected by gender (p = 0.005). CONCLUSION The WST for scooters has good test-retest reliability and generally varies as anticipated with other measures. Although further study is needed, the WST for scooters appears to have promise for use in research and clinical practice. Implications for Rehabilitation It is important to understand the measurement properties of the tools we use in rehabilitation so the results can be interpreted correctly. As scooter use increases, better measurement of skills is required.
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Affiliation(s)
- W Ben Mortenson
- a Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , BC , Canada.,b International Collaboration on Repair Discoveries (ICORD), UBC Faculty of Medicine and Vancouver Coastal Health (VCH) Research Institute , Vancouver , BC , Canada.,c Rehabilitation Research Program, VCH Research Institute , Vancouver , BC , Canada
| | - Laura Hurd Clarke
- d School of Kinesiology , University of British Columbia , Vancouver , BC , Canada
| | - Charlie H Goldsmith
- a Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , BC , Canada.,e Faculty of Health Sciences , Simon Fraser University , Burnaby , BC , Canada
| | - Sharon Jang
- b International Collaboration on Repair Discoveries (ICORD), UBC Faculty of Medicine and Vancouver Coastal Health (VCH) Research Institute , Vancouver , BC , Canada.,c Rehabilitation Research Program, VCH Research Institute , Vancouver , BC , Canada
| | - R Lee Kirby
- f Division of Physical Medicine and Rehabilitation, Department of Medicine , Dalhousie University , Halifax , NS , Canada
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Harris A, Pinnington LL, Ward CD. Evaluating the Impact of Mobility-Related Assistive Technology on the Lives of Disabled People: A Review of Outcome Measures. Br J Occup Ther 2016. [DOI: 10.1177/030802260506801204] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sixteen outcome measures that could be used within the field of mobility assistive technology were reviewed. The aim was to assess how these tools measured activity and participation in relation to mobility. Each measure considered some useful aspect of participation, but none took sufficient account of the needs of those with mobility impairments or could evaluate adequately the impact of different technologies. To support client-centred and evidence-based practice, an outcome measure that evaluates the impact of mobility assistive technology on activity and participation is required.
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11
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Kirby RL, Worobey LA, Cowan R, Pedersen JP, Heinemann AW, Dyson-Hudson TA, Shea M, Smith C, Rushton PW, Boninger ML. Wheelchair Skills Capacity and Performance of Manual Wheelchair Users With Spinal Cord Injury. Arch Phys Med Rehabil 2016; 97:1761-9. [PMID: 27317867 DOI: 10.1016/j.apmr.2016.05.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/30/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To describe the wheelchair skills capacity and performance of experienced manual wheelchair users with spinal cord injury (SCI) and to assess measurement properties of the Wheelchair Skills Test (WST) and Wheelchair Skills Test Questionnaire (WST-Q). DESIGN Cross-sectional descriptive study involving within-subject comparisons. SETTING Four Spinal Cord Injury Model Systems centers. PARTICIPANTS Manual wheelchair users with SCI (N=117). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES WST and WST-Q version 4.2 as well as measures for Confidence, Basic Mobility, Independence, Ability to Participate, Satisfaction, and Pain Interference. RESULTS The median (interquartile range) values for WST capacity, WST-Q capacity, and WST-Q performance were 81.0% (69.0%-90.0%), 88.0% (77.0%-97.0%), and 76.0% (66.3%-84.0%). The total WST capacity scores correlated significantly with the total WST-Q capacity scores (r=.76; P<.01) and WST-Q performance scores (r=.55; P<.01). The total WST-Q capacity and WST-Q performance scores were correlated significantly (r=.63; P<.001). Success rates were <75% for 10 of the 32 (31%) individual skills on the WST and 6 of the 32 (19%) individual skills on the WST-Q. Regression models for the total WST and WST-Q measures identified statistically significant predictors including age, sex, body mass index, and/or level of injury. The WST and WST-Q measures correlated significantly with the Confidence, Basic Mobility, Independence, or Pain Interference measures. CONCLUSIONS Many people with SCI are unable to or do not perform some of the wheelchair skills that would allow them to participate more fully. More wheelchair skills training may enhance participation and quality of life of adults with SCI. The WST and WST-Q exhibit good content, construct, and concurrent validity.
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Affiliation(s)
- R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada.
| | - Lynn A Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
| | - Rachel Cowan
- The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami, Miami, FL
| | | | | | | | - Mary Shea
- Kessler Institute for Rehabilitation, West Orange, NJ
| | - Cher Smith
- Capital District Health Authority, Halifax, NS
| | - Paula W Rushton
- School of Rehabilitation, Occupational Therapy Program, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
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12
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Saltan A, Bakar Y, Ankarali H. Wheeled mobility skills of wheelchair basketball players: a randomized controlled study. Disabil Rehabil Assist Technol 2016; 12:390-395. [PMID: 27291563 DOI: 10.1080/17483107.2016.1177857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to assess the influence of wheelchair basketball sport on the functional abilities of wheelchair users. METHOD This is a randomized controlled study. Wheelchair basketball players (n = 111) and non-player (n = 85) were included in this study. We administered the questionnaire version of the wheelchair skills test questionnaire (WST_Q), recording the participants' capacity and performance scores on each of 32 skills. RESULTS Player group have the baseline values of WST_Q higher than control group. The mean total percentage score of player group was significantly greater than control group (p < 0.05). The get over 15 cm level (respectively, rations of capacity and performance of groups: player/control: 50.5-20% and 54.1-24.7%) and the ascends 10° incline (player/control 96.4-48.2% and 98.2-54.1%). CONCLUSIONS Participation in regular wheelchair basketball sport may preserve and augment functional abilities in with wheelchair user Implications for rehabilitation The skills-sports relationship is reciprocal. With increased wheelchair skills, people may be more inclined to engage in sports; subsequently, with greater sports, wheelchair skills could improve. Wheelchair mobility skills during clinical rehabilitation should reflect the daily activities and needs of each wheelchair user. WST-Q provides advantages in terms of requiring less time and material in using of clinical.
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Affiliation(s)
- Asuman Saltan
- a Termal Vocational School, University of Yalova , Yalova , Turkey
| | - Yeşim Bakar
- b University of Abant Izzet Baysal, University of Bolu , Bolu , Turkey
| | - Handan Ankarali
- c Department of Medical Informatics , School of Medicine and Biostatistics, Duzce University , Duzce , Turkey
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Rushton PW, Kirby RL, Routhier F, Smith C. Measurement properties of the Wheelchair Skills Test-Questionnaire for powered wheelchair users. Disabil Rehabil Assist Technol 2014; 11:400-6. [PMID: 25411057 DOI: 10.3109/17483107.2014.984778] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the test-retest reliability, concurrent validity and responsiveness of the Wheelchair Skills Test - Questionnaire (WST-Q) Version 4.1 for powered wheelchair users. METHODS A volunteer sample of 72 community-dwelling, experienced powered wheelchair users, ranging in age from 50 to 77 years, participated in this study. Participants completed measures at baseline and 1 month later. RESULTS Mean ± standard deviation total percentage WST-Q scores at baseline and 1 month were 83.7% ± 10.9 and 86.3% ± 10.0 respectively. Cronbach's alpha was 0.90 and the 1 month test-retest intraclass correlation coefficient (ICC1,1) was 0.78 (confidence interval: 0.68-0.86). There were no floor or ceiling effects. Percentages of agreement between baseline and 1 month for individual skills ranged from 72.2% to 100%. The correlations between the WST-Q and the objective Wheelchair Skills Test (WST), WheelCon and Life Space Assessment were r = 0.65, r = 0.47 and r = 0.47 respectively. The standard error of measurement (SEM) and smallest real difference (SRD) were 5.0 and 6.2 respectively. CONCLUSION The WST-Q 4.1 has high internal consistency, strong test-retest reliability and strong support for concurrent validity and responsiveness. IMPLICATIONS FOR REHABILITATION There is evidence of reliability, validity and responsiveness of the Wheelchair Skills Test - Questionnaire (WST-Q) among experienced older adult powered wheelchair users. The WST-Q can be used to measure powered wheelchair skills, guide intervention and measure change over time.
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Affiliation(s)
- Paula W Rushton
- a École de réadaptation, Université de Montréal , Montréal , QC , Canada .,b Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal , Montréal , QC , Canada
| | - R Lee Kirby
- c Division of Physical Medicine and Rehabilitation , Dalhousie University , Halifax , NS , Canada
| | - Francois Routhier
- d Department of Rehabilitation , Université Laval , Québec City , QC , Canada .,e Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec , Québec City , QC , Canada , and
| | - Cher Smith
- f Department of Occupational Therapy , Nova Scotia Rehabilitation Centre Site, Queen Elizabeth II Health Sciences Centre , Halifax , NS , Canada
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Tsai CY, Hogaboom NS, Boninger ML, Koontz AM. The relationship between independent transfer skills and upper limb kinetics in wheelchair users. BIOMED RESEARCH INTERNATIONAL 2014; 2014:984526. [PMID: 25162039 PMCID: PMC4139077 DOI: 10.1155/2014/984526] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/09/2014] [Indexed: 11/17/2022]
Abstract
Transfers are one of the most physically demanding wheelchair activities. The purpose of this study was to determine if using proper transfer skills as measured by the Transfer Assessment Instrument (TAI) is associated with reduced loading on the upper extremities. Twenty-three wheelchair users performed transfers to a level-height bench while a series of forces plates, load cells, and a motion capture system recorded the biomechanics of their natural transferring techniques. Their transfer skills were simultaneously evaluated by two study clinicians using the TAI. Logistic regression and multiple linear regression models were used to determine the relationships between TAI scores and the kinetic variables on both arms across all joints. The results showed that the TAI measured transfer skills were closely associated with the magnitude and timing of joint moments (P < .02, model R(2) values ranged from 0.27 to 0.79). Proper completion of the skills which targeted the trailing arm was associated with lower average resultant moments and rates of rise of resultant moments at the trailing shoulder and/or elbow. Some skills involving the leading side had the effect of increasing the magnitude or rate loading on the leading side. Knowledge of the kinetic outcomes associated with each skill may help users to achieve the best load-relieving effects for their upper extremities.
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Affiliation(s)
- Chung-Ying Tsai
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Nathan S. Hogaboom
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Michael L. Boninger
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Alicia M. Koontz
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, PA 15206, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15261, USA
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Tsai CY, Rice LA, Hoelmer C, Boninger ML, Koontz AM. Basic Psychometric Properties of the Transfer Assessment Instrument (Version 3.0). Arch Phys Med Rehabil 2013; 94:2456-2464. [DOI: 10.1016/j.apmr.2013.05.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 04/19/2013] [Accepted: 05/07/2013] [Indexed: 11/26/2022]
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Rushton PW, Kirby RL, Miller WC. Manual wheelchair skills: objective testing versus subjective questionnaire. Arch Phys Med Rehabil 2012; 93:2313-8. [PMID: 22728701 DOI: 10.1016/j.apmr.2012.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 05/07/2012] [Accepted: 06/04/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test the hypothesis that the total scores of the Wheelchair Skills Test (WST) version 4.1, an observer-rated scale of wheelchair performance, and the Wheelchair Skills Test Questionnaire (WST-Q) version 4.1, a self-report of wheelchair skills, are highly correlated. We also anticipate that the WST-Q scores will be slightly higher, indicating an overestimation of capacity to perform wheelchair skills as compared with actual capacity. DESIGN A cross-sectional, within-subjects comparison design. SETTING Three Canadian cities. PARTICIPANTS Convenience sample of community-dwelling, experienced manual wheelchair users (N=89) ranging in age from 21 to 94 years. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Participants completed the subjective WST-Q version 4.1 followed by the objective WST version 4.1 in 1 testing session. RESULTS The mean ± SD total percentage scores for WST and WST-Q were 79.5%±14.4% and 83.0%±12.1% for capacity and 99.4%±1.5% and 98.9%±2.5% for safety, respectively. The correlations between the WST and WST-Q scores were ρ=.89 (P=.000) for capacity and ρ=.12 (P=.251) for safety. WST-Q total score mean differences were an average of 3.5%±6.5% higher than WST scores for capacity (P=.000) and .52%±2.8% lower for safety (P=.343). For the 32 individual skills, the percentage agreement between the WST and WST-Q scores ranged from 82% to 100% for capacity and from 90% to 100% for safety. CONCLUSION WST and WST-Q version 4.1 capacity scores are highly correlated although the WST-Q scores are slightly higher. Decisions on which of these assessments to use can safely be based on the circumstances and objectives of the evaluation.
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Affiliation(s)
- Paula W Rushton
- Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada.
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Inkpen P, Parker K, Kirby RL. Manual Wheelchair Skills Capacity Versus Performance. Arch Phys Med Rehabil 2012; 93:1009-13. [DOI: 10.1016/j.apmr.2011.11.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/31/2011] [Accepted: 11/20/2011] [Indexed: 11/16/2022]
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Routhier F, Kirby RL, Demers L, Depa M, Thompson K. Efficacy and retention of the French-Canadian version of the wheelchair skills training program for manual wheelchair users: a randomized controlled trial. Arch Phys Med Rehabil 2012; 93:940-8. [PMID: 22494946 PMCID: PMC3708861 DOI: 10.1016/j.apmr.2012.01.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 01/24/2012] [Accepted: 01/24/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To test the hypotheses that, in comparison with a control group that received standard care, users of manual wheelchairs who also received the French-Canadian version of the Wheelchair Skills Training Program (WSTP) would significantly improve their wheelchair-skills capacity and that these improvements would be retained at 3 months. DESIGN Multicenter, single-blind, randomized controlled trial. SETTING Three rehabilitation centers in Montréal, Quebec, Canada. PARTICIPANTS Manual wheelchair users (N=39), a sample of convenience. INTERVENTION Participants were randomly allocated to the WSTP or control groups. Participants in both groups received standard care. Participants in the WSTP group also received a mean of 5.9 training sessions (a mean total duration of 5h and 36min). MAIN OUTCOME MEASURES The French-Canadian version of the Wheelchair Skills Test (WST) (Version 3.2) was administered at evaluation at first time period (baseline) (t1), evaluation at second time period (posttraining) (t2) (a mean of 47d after t1), and at evaluation at third time period (follow-up) (t3) (a mean of 101d after t2). RESULTS At t2, the mean ± SD total percentage WST capacity scores were 77.4%±13.8% for the WSTP group and 69.8%±18.4% for the control group (P=.030). Most of this difference was due to the community-level skills (P=.002). The total and subtotal Wheelchair Skills Test scores at t3 decreased by ≤0.5% from the t2 values, but differences between groups at t3, adjusting for t1, did not reach statistical significance (P≥.017 at a Bonferroni-adjusted α level of .005). CONCLUSION WSTP training improves wheelchair skills immediately after training, particularly at the community-skills level, but this study did not show statistically significant differences between the groups at 3 months.
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Affiliation(s)
- François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec, Québec City, Québec, Canada.
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De Groot S, Balvers IJM, Kouwenhoven SM, Janssen TWJ. Validity and reliability of tests determining performance-related components of wheelchair basketball. J Sports Sci 2012; 30:879-87. [PMID: 22489567 DOI: 10.1080/02640414.2012.675082] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The purpose of this study was to investigate the reliability and validity of wheelchair basketball field tests. Nineteen wheelchair basketball players performed 10 test items twice to determine the reliability. The validity of the tests was assessed by relating the scores to the players' classification and competition standard, and rating of coach and player. Six field tests' test-retest showed good reliability (Intraclass correlation coefficient (ICC) = 0.80-0.97), while the pass-for-accuracy, free throws, lay-up and spot shot showed weak to moderate reliability (ICC = 0.26-0.67). Most tests showed moderate to good validity (r > 0.60). The results suggest that wheelchair basketball field tests are reliable and valid with the exception of the shooting and passing items, which should be interpreted carefully.
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Affiliation(s)
- Sonja De Groot
- Amsterdam Rehabilitation Research Institute, Reade, Centre for Rehabilitation and Rheumatology, The Netherlands.
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20
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Évaluation d’un prototype du fauteuil roulant par le « Programme d’habiletés en fauteuil roulant® » pour des sujets paraplégiques. Sci Sports 2011. [DOI: 10.1016/j.scispo.2010.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Reliability and Validity Analysis of the Transfer Assessment Instrument. Arch Phys Med Rehabil 2011; 92:499-508. [DOI: 10.1016/j.apmr.2010.07.231] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 06/28/2010] [Accepted: 07/01/2010] [Indexed: 11/23/2022]
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Maheu V, Frappier J, Archambault PS, Routhier F. Evaluation of the JACO robotic arm: clinico-economic study for powered wheelchair users with upper-extremity disabilities. IEEE Int Conf Rehabil Robot 2011; 2011:5975397. [PMID: 22275600 DOI: 10.1109/icorr.2011.5975397] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Many activities of daily living, such as picking up glasses, holding a fork or opening a door, which most people do without thinking, can become insurmountable for people who have upper extremity disabilities. The alternative to asking for human help is to use some assistive devices to compensate their loss of mobility; however, many of those devices are limited in terms of functionality. Robotics may provide a better approach for the development of assistive devices, by allowing greater functionality. In this paper, we present results of a study (n=31) which objectives were to evaluate the efficacy of a new joystick-controlled seven-degree of freedom robotic manipulator and assess its potential economic benefits. Results show that JACO is easy to use as the majority of the participants were able to accomplish the testing tasks on their first attempt. The economic model results inferred that the use of the JACO arm system could potentially reduce caregiving time by 41%. These study results are expected to provide valuable data for interested parties, such as individuals with disabilities, their family or caregivers.
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de Groot S, Bevers GE, Dallmeijer AJ, Post MWM, van Kuppevelt HJM, van der Woude LHV. Development and validation of prognostic models designed to predict wheelchair skills at discharge from spinal cord injury rehabilitation. Clin Rehabil 2009; 24:168-80. [DOI: 10.1177/0269215509343248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To develop and validate a statistical model to predict wheelchair skills at discharge (t 2) from personal and lesion characteristics and wheelchair skills at the start of spinal cord injury inpatient rehabilitation (t1). Design: Prospective cohort study Setting: Eight Dutch rehabilitation centres. Subjects: One hundred and forty-two patients with a spinal cord injury. Main measures: Models were developed with the performance time and ability score at t2 as dependent variables and t1 scores of performance time and ability score, age, gender, body mass index, level and completeness of the lesion as independent variables. The statistical models were evaluated by comparing individual estimated scores with actual measured scores. Results: The main independent variables to predict wheelchair skills at discharge were the t1 performance time and ability score, age, gender and lesion level. The intraclass correlation coefficient between the estimated and actual ability score was 0.79 and for the performance time 0.86. However, the 95% limits of agreement and their confidence intervals were relatively wide for both ability score (—2.3 to 3.4, range 0—8) and performance time (—12.5 to 8.2, range 11—40 seconds). Conclusion: The prognostic models developed in this study to predict future wheelchair skills might help planning the course of rehabilitation. The models should be used with caution in daily clinical practice, but may add useful information to clinical expertise and knowledge of the individual patient.
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Affiliation(s)
- S. de Groot
- Rehabilitation Center Amsterdam and Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen,
| | - GE Bevers
- Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam
| | - AJ Dallmeijer
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam
| | - MWM Post
- Rehabilitation Center De Hoogstraat and Rudolf Magnus Institute for Neuroscience, University Medical Center, Utrecht
| | | | - LHV van der Woude
- Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, The Netherlands
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Laffont I, Guillon B, Fermanian C, Pouillot S, Even-Schneider A, Boyer F, Ruquet M, Aegerter P, Dizien O, Lofaso F. Evaluation of a Stair-Climbing Power Wheelchair in 25 People With Tetraplegia. Arch Phys Med Rehabil 2008; 89:1958-64. [DOI: 10.1016/j.apmr.2008.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 03/12/2008] [Accepted: 03/20/2008] [Indexed: 10/21/2022]
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Holliday PJ, Mihailidis A, Rolfson R, Fernie G. Understanding and measuring powered wheelchair mobility and manoeuvrability. Part I. Reach in confined spaces. Disabil Rehabil 2006; 27:939-49. [PMID: 16096247 DOI: 10.1080/09638280500052799] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine: (1) what wheelchair manoeuvrability factors are important and (2) the effects of powered wheelchair design on the ability to reach in a confined space. METHOD The relative importance of five aspects of wheelchair manoeuvrability was determined through a survey of users of wheelchairs (N = 52) and health care professionals and others (N = 89). A single young, non-disabled subject undertook repeated trials of reach distance on to a counter at the end of a corridor whose width could be adjusted by moving Styrofoam walls. RESULTS Reaching, moving in confined spaces and avoiding collisions were more important than speed and avoiding the need to drive backwards. The rear wheel drive powered wheelchair was found to allow the greatest reach when driving backwards into the space and the wheelchair which moved in a sideways direction allowed greatest reach in the narrowest corridor. CONCLUSIONS The survey concluded that manoeuvring in small spaces and reaching without collisions were important. The powered wheelchair with sideways capability afforded the greatest reach in confined spaces except when the rear wheel drive chair was driven in backwards. The survey respondents did not place a high priority on avoiding backwards driving but some people find this difficult to do safely.
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Affiliation(s)
- P J Holliday
- Centre for Studies in Aging, Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada, M4N 3M5.
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Best KL, Kirby RL, Smith C, MacLeod DA. Wheelchair Skills Training for Community-Based Manual Wheelchair Users: A Randomized Controlled Trial. Arch Phys Med Rehabil 2005; 86:2316-23. [PMID: 16344029 DOI: 10.1016/j.apmr.2005.07.300] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2005] [Revised: 06/15/2005] [Accepted: 07/05/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To test the hypotheses that wheelchair skills training of community-based manual wheelchair users is efficacious, safe, and practical. DESIGN Randomized controlled trial. SETTING Rehabilitation center and community. PARTICIPANTS Twenty community-based manual wheelchair users (15 men, 5 women; age range, 21-77 y), half with musculoskeletal and half with neurologic disorders. INTERVENTION Participants were randomly allocated to the Wheelchair Skills Training Program (WSTP) or control groups. In 1-hour individualized sessions, the WSTP group participants received a mean +/- standard deviation of 4.5+/-0.7 hours of training. Caregivers participated whenever possible. In addition to training at the rehabilitation center, the trainer traveled to administer training in the community. MAIN OUTCOME MEASURES Using the Wheelchair Skills Test (WST, version 3.1), an objective test of 57 skills, we calculated total and subtotal percentage scores (percentage number of skills passed of those possible) and individual skill success rates. RESULTS The WSTP group's improvement in total WST score was significantly greater than the control group's (P<.005). The mean total WST score for the WSTP group increased from a pretraining value of 63.3%+/-6.0% to 78.5%+/-8.3% posttraining, a relative improvement of 24.0% (P=.002). The control group increased from a baseline value of 70.8%+/-14.0% to 74.2%+/-11.8% at follow-up, a relative improvement of 4.8% (P=.03). The WSTP group had clinically significant pre- and posttraining improvements (> or = 20%) in the success rates of 25 of the 57 individual WST skills, compared with only 5 skills for the control group. There were no adverse incidents, and the WSTP participants' comments were all positive. CONCLUSIONS Wheelchair skills training of community-based manual wheelchair users is efficacious, safe, and practical. These findings have implications for the standard of rehabilitation care.
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Affiliation(s)
- Krista L Best
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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Kirby RL, Mifflen NJ, Thibault DL, Smith C, Best KL, Thompson KJ, MacLeod DA. The manual wheelchair-handling skills of caregivers and the effect of training. Arch Phys Med Rehabil 2005; 85:2011-9. [PMID: 15605341 DOI: 10.1016/j.apmr.2004.02.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To test the hypothesis that the Wheelchair Skills Training Program (WSTP) is effective in improving the wheelchair-handling skills of untrained caregivers. DESIGN Within-participant comparisons. SETTING Rehabilitation center and community. PARTICIPANTS Twenty-four caregivers of manual wheelchair users. INTERVENTIONS Caregiver participants underwent the WSTP, version 2.4, adapted for caregivers. Training was individualized on the basis of an integrated testing-and-training protocol that took place on a single occasion (total, approximately 50 min). MAIN OUTCOME MEASURES Total percentage scores on the objective Wheelchair Skills Test (WST), version 2.4, for the pretraining (N=24), posttraining (N=24), and retention (n=9) evaluations. For the skill-transfer evaluation (n=10), we used the questionnaire version (WST-Q), administered by telephone to participants after return to their communities. RESULTS There were no serious adverse incidents. The mean pretraining total WST score +/- standard deviation was 77.8%+/-12.0%. Posttraining, this increased to 94.7%+/-7.1% (P <.001), a 22% relative increase. At retention testing, a median latency of 7 days later, the mean value, 94.2%+/-7.1%, did not decrease significantly from the posttraining level (P =.38). At skill-transfer testing, a median latency of 179 days posttraining, the mean value, 92.5%+/-8.7%, did not decrease significantly from the posttraining level (P =.73). The greatest improvements were at the advanced skill level. CONCLUSIONS The WSTP is a safe, practical, and effective method of improving the wheelchair-handling skills of untrained caregivers. Skill improvements are generally well retained and transfer well to the community. Such training could play an important role in the rehabilitation process.
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Affiliation(s)
- R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada.
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Jonkers I, Nuyens G, Seghers J, Nuttin M, Spaepen A. Muscular effort in multiple sclerosis patients during powered wheelchair manoeuvres. Clin Biomech (Bristol, Avon) 2004; 19:929-38. [PMID: 15475125 DOI: 10.1016/j.clinbiomech.2004.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2003] [Accepted: 06/08/2004] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study applied EMG analysis methods to identify muscle group activity profiles and potential overload risks in powered wheelchair use. METHODS We quantified muscle effort and fatigue using EMG analysis methods during powered wheelchair manoeuvres by 10 multiple sclerosis patients. Video recordings of the different sub-tasks were related to information on surface EMG amplitude (rectified EMG) and spectral information (Median frequency) from M. trapezius, M. deltoideus (pars medius), M. deltoideus (pars anterior), M. pectoralis, M. biceps, M. triceps, wrist extensors and flexors, using Joint Analysis of EMG Spectrum and Amplitude (JASA analysis). FINDINGS Task durations and subjective data indicated that tasks requiring finer motor control took longer and were perceived as more difficult. Kinesiological functions of all muscle groups identified forward steering to be associated with activation of M. deltoideus (pars anterior), M. pectoralis, M. trapezius and M. deltoideus (pars medius); backwards steering with predominant activation of M. deltoideus (pars medius), M. biceps brachii and wrist flexors; left steering with maximal activation of M. biceps and wrist flexors, and right steering with maximal activation of M. triceps and wrist extensors. These profiles were confirmed in analysis of the functional tasks. JASA analysis documented muscle fatigue in the wrist extensors, whereas increased activation was found in M. trapezius, M. deltoideus (pars anterior) and wrist flexors. INTERPRETATION EMG based kinesiological analysis gives insight in muscle activity and fatigue during powered wheelchair manoeuvres.
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Affiliation(s)
- I Jonkers
- Laboratory of Ergonomics and Occupational Biomechanics, Faculty of Physical Education and Physiotherapy, Kinesiology Department, Katholieke Universiteit Leuven, Leuven, Belgium.
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May LA, Butt C, Kolbinson K, Minor L, Tulloch K. Wheelchair back-support options: functional outcomes for persons with recent spinal cord injury. Arch Phys Med Rehabil 2004; 85:1146-50. [PMID: 15241766 DOI: 10.1016/j.apmr.2003.08.105] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the functional outcomes for people with a recent spinal cord injury (SCI) when using 3 different back-support options. DESIGN Repeated-measures within-subject comparison. SETTING Rehabilitation center. PARTICIPANTS Twenty-seven manual wheelchair users with recent SCI. INTERVENTIONS Three types of wheelchair back supports--a standard sling upholstery, a Jay J2 back, and a Pindot PaxBac--were used by each participant to evaluate performance of 4 functional tasks. MAIN OUTCOME MEASURES Functional tasks included timed forward wheeling, ramp ascent, distance for forward vertical reach, and 1-stroke push. Product satisfaction was also rated. RESULTS For most participants, best performance for each task varied with back support used. Significant differences in functional performance were found for the reaching activity (P=.01), with greater reach when the J2 was used. Satisfaction ratings also differed significantly (P=.017), with participants indicating greater satisfaction with the J2. Participants' choice of back support varied and did not consistently correspond with best performance. CONCLUSIONS Except for reaching, performance of functional activities did not differ depending on back support used. Objective evaluation of reaching ability may assist in product decision making. Inclusion of a consistent battery of functional tasks could provide a standardized reference point for clients' subjective evaluations.
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Affiliation(s)
- Laura A May
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, 2-50 Corbett Hall, University of Alberta, Edmonton, Alberta, Canada T6G 2G4.
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Coolen AL, Kirby RL, Landry J, MacPhee AH, Dupuis D, Smith C, Best KL, Mackenzie DE, MacLeod DA. Wheelchair skills training program for clinicians: a randomized controlled trial with occupational therapy students. Arch Phys Med Rehabil 2004; 85:1160-7. [PMID: 15241768 DOI: 10.1016/j.apmr.2003.10.019] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To test the hypothesis that a brief formalized period of wheelchair skills training, added to the standard curriculum, results in significantly greater overall improvements in wheelchair skills than a standard undergraduate occupational therapy (OT) curriculum alone. SETTING Rehabilitation center. DESIGN Randomized controlled trial. PARTICIPANTS Eighty-two students in a university undergraduate OT program. INTERVENTIONS All students received the standard university curriculum. The 22 second-year students, randomly allocated to the Wheelchair Skills Training Program (WSTP) group, were also trained (on a single occasion each, in groups of 1-3 at a time) on the 50 skills that make up the WSTP. The mean +/- standard deviation (SD) training time was 121.2+/-33.5 minutes per group. MAIN OUTCOME MEASURE Total percentage score on the Wheelchair Skills Test (WST), Version 2.4. RESULTS From before to after intervention, second-year students in the WSTP group increased their mean percentage WST scores +/- SD from 64.8%+/-9.0% to 81.0%+/-5.2%, a 25% improvement (P<.001). Over a comparable period, the 18 students in the second-year control group increased from 66.0%+/-8.0% to 72.4%+/-7.1%, a 9.7% improvement (P=.015). The WSTP group improved to a significantly greater extent (P=.005). For a subset of 8 students in the WSTP group who were retested 9 to 12 months later, the mean WST score was 79.7%+/-4.1%, not significantly less than their WST 2 scores (P=.29). The mean WST score for the 42 students in the fourth-year control group was 73.9%+/-4.1%, significantly lower than the mean postintervention WST score of the second-year students in the WSTP group (P< .0001) and not different from the second-year control group (P=.58). CONCLUSIONS The WSTP is an effective way to improve the wheelchair-skills performance of OT students. This has implications for the education of all rehabilitation clinicians.
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Affiliation(s)
- Anna L Coolen
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia B3H 4K4, Canada
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Kirby RL, Dupuis DJ, Macphee AH, Coolen AL, Smith C, Best KL, Newton AM, Mountain AD, Macleod DA, Bonaparte JP. The wheelchair skills test (version 2.4): measurement properties11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated. Arch Phys Med Rehabil 2004; 85:794-804. [PMID: 15129405 DOI: 10.1016/j.apmr.2003.07.007] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To evaluate the measurement properties of the Wheelchair Skills Test (WST), version 2.4. DESIGN Cohort study. SETTING Rehabilitation center. PARTICIPANTS A total of 298 subjects (169 wheelchair users, 129 able-bodied subjects) ranging in age from 17 to 88 years. INTERVENTION We videotaped subjects as they attempted the 50 skills of the WST 2.4. MAIN OUTCOME MEASURES The test-retest, intrarater, and interrater reliabilities were determined on a subset of 20 wheelchair users. We assessed construct validity by evaluating whether the WST detected expected changes and concurrent validity by seeing how well total WST scores correlated with criterion measures. RESULTS The mean time +/- standard deviation taken to administer the WST was 27.0+/-9.3 minutes. There were no serious adverse incidents, and the test was well tolerated. For the test-retest, intrarater and interrater reliabilities, the intraclass correlation coefficients for the total scores were.904,.959, and.968. For individual skills, the percentage concordance ranged from 73% to 100%. Regarding construct validity, there was a slightly negative Pearson correlation between total WST score and age (-.434). Gender was identified as a significant factor on multiple regression analysis (P<.001). Wheelchair users with more than 21 days of experience scored higher than those with less experience (65.0% vs 59.6%; P=.01). Participants with stroke and related disorders had a mean score (55.0%+/-13.9%) that was significantly lower than those in other diagnostic categories (P<.05). Participants using conventional wheelchairs had lower scores than those in lightweight ones (66.4% vs 75.1%; P<.001). Regarding concurrent validity, Spearman rank correlations between total WST scores and the global assessments of the wheelchair users' therapists and admission and discharge FIM instrument scores were.394,.38, and.31. CONCLUSIONS The WST 2.4 is practical and safe, and its measurement properties are very good to excellent. Further study is needed to determine its usefulness in various clinical settings.
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Affiliation(s)
- R Lee Kirby
- Department of Medicine, Dalhousie University, Halifax, NS, Canada.
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Mountain AD, Kirby RL, Smith C. The wheelchair skills test, version 2.4: Validity of an algorithm-based questionnaire version. Arch Phys Med Rehabil 2004; 85:416-23. [PMID: 15031827 DOI: 10.1016/s0003-9993(03)00427-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the hypothesis that an algorithm-based questionnaire version of the Wheelchair Skills Test (WST) would provide a valid assessment of manual wheelchair skills. DESIGN Within-participant comparisons. SETTING Rehabilitation center in Nova Scotia, Canada. PARTICIPANTS Twenty wheelchair users, 11 with musculoskeletal and 9 with neurologic disorders, with a wide range of wheelchair experience (1wk-20y). INTERVENTION Each participant completed the questionnaire (WST-Q) and then the objective skills testing (WST, version 2.4). MAIN OUTCOME MEASURE The WST-Q consisted of 3 components, reported as separate versions: the knowledge version (WST-Q [K]) (structured oral questions only); the visual-aid version (WST-Q [VA]) (visual aids added for 6 of the skills); and the categorical perceived-ability version (WST-Q [PA]). RESULTS The mean total percentage scores for the WST-Q (K), WST-Q (VA), WST-Q (PA), and WST were 60.5%, 62.2%, 64.0%, and 59.8%, respectively. Only the WST-Q (PA) differed significantly from the WST (P<.05). Positive correlations existed between the objective WST and the WST-Q (K) (r=.91), WST-Q (VA) (r=.91), and WST-Q (PA) (r=.83). The percentage agreement on the individual skill scores ranged from 55% to 100%. CONCLUSIONS The algorithm-based WST-Q has excellent concurrent validity in comparison with objective testing, when assessing the overall manual wheelchair skill levels of wheelchair users with a wide range of experience. It may be useful as a screening tool or when objective testing is impractical.
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Affiliation(s)
- Anita D Mountain
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS
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Kilkens OJ, Dallmeijer AJ, De Witte LP, Van Der Woude LH, Post MW. The wheelchair circuit: construct validity and responsiveness of a test to assess manual wheelchair mobility in persons with spinal cord injury. Arch Phys Med Rehabil 2004; 85:424-31. [PMID: 15031828 DOI: 10.1016/j.apmr.2003.05.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the validity and responsiveness of the Wheelchair Circuit, a test to assess manual wheelchair mobility in persons with spinal cord injury (SCI). DESIGN Longitudinal. Subjects performed the Wheelchair Circuit at the start (T1) and at the end (T3) of inpatient functional rehabilitation. Construct validity and responsiveness were assessed. SETTING Eight rehabilitation centers in the Netherlands. PARTICIPANTS Seventy-four subjects with SCI admitted for inpatient rehabilitation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Wheelchair Circuit consists of 8 wheelchair skills and results in 3 test scores: ability, performance time, and physical strain. The construct validity of the Wheelchair Circuit was assessed by testing whether the test scores were significantly related to the subjects' functional status, physical capacity, lesion level, motor completeness of the lesion, and age. To prove the test's responsiveness, it was assessed whether the test scores had significantly improved between T1 and T3. RESULTS For construct validity, 4 of the 5 hypotheses were confirmed. For test responsiveness, all 3 test scores had significantly improved during rehabilitation, and the standardized response mean values ranged from 0.6 to 0.9. CONCLUSIONS The Wheelchair Circuit is a valid and responsive instrument with which to measure manual wheelchair mobility in subjects with SCI.
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Affiliation(s)
- Olga J Kilkens
- iRv, Institute for Rehabilitation Research, Hoensbroek, the Netherlands.
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