Development of a wheelchair mobility skills test for children and adolescents: combining evidence with clinical expertise

Design and Implementation of a Position, Speed and Orientation Fuzzy Controller Using a Motion Capture System to Operate a Wheelchair Prototype

The design and implementation of an electronic system that involves head movements to operate a prototype that can simulate future movements of a wheelchair was developed here. The controller design collects head-movements data through a MEMS sensor-based motion capture system. The research was divided into four stages: First, the instrumentation of the system using hardware and software; second, the mathematical modeling using the theory of dynamic systems; third, the automatic control of position, speed, and orientation with constant and variable speed; finally, system verification using both an electronic controller test protocol and user experience. The system involved a graphical interface for the user to interact with it by executing all the controllers in real time. Through the System Usability Scale (SUS), a score of 78 out of 100 points was obtained from the qualification of 10 users who validated the system, giving a connotation of “very good”. Users accepted the system with the recommendation to improve safety by using laser sensors instead of ultrasonic range modules to enhance obstacle detection.

The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair

PURPOSE

To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness.

METHODS

Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test.

RESULTS

Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility.

CONCLUSIONS

A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.

Protocolo Avaliativo de Iniciação Esportiva em Cadeira de Rodas: uma alternativa de avaliação para pessoas com deficiência física

RESUMO O estudo teve como objetivo apresentar o Protocolo Avaliativo de Iniciação Esportiva em Cadeira de Rodas - PAIE-CR e verificar em quais áreas dos componentes motores (habilidades motoras fundamentais e capacidades físicas), um programa de iniciação esportiva em cadeira de rodas exerceu influência, antes e após a intervenção proposta. A intervenção foi composta por 24 sessões. Participaram desse estudo três crianças (6 a 10 anos) com deficiência física, comprometimento nos membros inferiores. O PAIE-CR é composto por nove testes divididos em quatro grupos de componentes: estabilização; locomoção; manipulação e combinados. Acredita-se que o instrumento oportuniza o acompanhamento e permite avaliar os componentes inerentes à iniciação esportiva em cadeira de rodas do educando.

Utrecht Pediatric Wheelchair Mobility Skills Test: Reliability, Validity, and Responsiveness in Youths Using a Manual Wheelchair

BACKGROUND

The assessment of wheelchair mobility skills (WMS) in youths using a manual wheelchair is important. More information is needed regarding the psychometric properties of the newly developed Utrecht Pediatric Wheelchair Mobility Skills Test (UP-WMST).

OBJECTIVE

The purpose of this study was to evaluate the reliability, content validity, construct validity, and responsiveness of the UP-WMST 2.0 in youths using a manual wheelchair.

DESIGN

This was a repeated-measurements, cross-sectional study.

METHODS

A total of 117 children and adolescents who use a manual wheelchair participated in this study. The UP-WMST 2.0 contains the same 15 WMS items as the original UP-WMST but has an adaptation of the scoring method. Test-retest reliability was estimated in 30 participants. Content validity was assessed through floor and ceiling effect analyses. Construct validity was assessed through hypothesis testing. Preliminary estimates of responsiveness were assessed in 23 participants who participated in a WMS training program.

RESULTS

Test-retest reliability analysis showed weighted Cohen kappa coefficients ranging from 0.63 to 0.98 for all but 1 item. The total UP-WMST 2.0 score had an intraclass correlation coefficient of 0.97. No floor or ceiling effects were detected. Independent-sample t test analysis confirmed our hypotheses regarding direction and difference in scores between age and diagnostic groups. Within-group analysis in the responsiveness study showed a positive significant change in UP-WMST 2.0 score (8.3 points).

LIMITATIONS

The small sample size used in the responsiveness study was a limitation of this study.

CONCLUSIONS

This study provided evidence of the test-retest reliability, content, and construct validity of the UP-WMST 2.0. It also provided initial evidence of the responsiveness of the UP-WMST 2.0 for measuring change in WMS in youths using a manual wheelchair.