Manual wheelchair skills capacity versus performance.

OBJECTIVES To test the hypotheses that self-reported manual wheelchair skills capacity and performance are highly correlated and that capacity significantly exceeds performance. DESIGN Cross-sectional. SETTING Rehabilitation center. PARTICIPANTS Manual wheelchair users (N=26) with a variety of diagnoses and an average of 10.8 years of wheelchair experience. INTERVENTIONS None. MAIN OUTCOME MEASURE We administered the questionnaire version of the Wheelchair Skills Test version 4.1 (WST-Q), recording the participants' capacity and performance scores on each of 32 skills. RESULTS The mean total WST-Q capacity and performance scores ± SD were 72.5%±19.2% and 58.1%±21.2%. The Spearman rho correlation coefficient between total WST-Q capacity and performance scores was .853 (P=.000). The mean difference ± SD in total WST-Q scores (capacity minus performance) was 14.4%±9.5% with a median of 10.9% (P=.000 on a Wilcoxon signed-rank test). There were 9 (28%) of the 32 skills for which the participants' mean capacity success rates were ≥20% higher than the mean performance success rates. Of the reasons for not performing individual skills, 66% of the instances were because the participant lacked the capacity. A variety of other reasons were given by participants for not performing skills of which they were capable (eg, the situation was not encountered, it could be avoided, or assistance was usually available). CONCLUSIONS Manual wheelchair skills capacity and performance are highly correlated but capacity exceeds performance, more so for some skills than others. Although further study is needed, these findings have implications for the assessment and training of wheelchair skills.

[1]  R. L. Kirby,et al.  Wheelchair-related falls in veterans with spinal cord injury residing in the community: a prospective cohort study. , 2010, Archives of physical medicine and rehabilitation.

[2]  L. V. D. van der Woude,et al.  A systematic review of wheelchair skills tests for manual wheelchair users with a spinal cord injury: towards a standardized outcome measure , 2010, Clinical rehabilitation.

[3]  M. Post,et al.  Return to work after spinal cord injury , 2000, Spinal Cord.

[4]  M. T. J. Buñuales,et al.  La clasificación internacional del funcionamiento de la discapacidad y de la salud (CIF) 2001 , 2002 .

[5]  R Lee Kirby,et al.  Wheelchair skills training program: A randomized clinical trial of wheelchair users undergoing initial rehabilitation. , 2004, Archives of physical medicine and rehabilitation.

[6]  L. V. D. van der Woude,et al.  Wheelchair skills tests: a systematic review , 2003, Clinical rehabilitation.

[7]  R Lee Kirby,et al.  The wheelchair skills test, version 2.4: Validity of an algorithm-based questionnaire version. , 2004, Archives of physical medicine and rehabilitation.

[8]  R Lee Kirby,et al.  Reliability of the performance and safety scores of the wheelchair skills test version 4.1 for manual wheelchair users. , 2010, Archives of physical medicine and rehabilitation.

[9]  Lucas H V van der Woude,et al.  Relationship between manual wheelchair skill performance and participation of persons with spinal cord injuries 1 year after discharge from inpatient rehabilitation. , 2005, Journal of rehabilitation research and development.

[10]  Krista L Best,et al.  The wheelchair skills test (version 2.4): measurement properties. , 2004, Archives of physical medicine and rehabilitation.

[11]  R Lee Kirby,et al.  Evaluation of manual wheelchair skills: is objective testing necessary or would subjective estimates suffice? , 2002, Archives of physical medicine and rehabilitation.

[12]  Helen Hoenig,et al.  A Clinical Trial of a Rehabilitation Expert Clinician Versus Usual Care for Providing Manual Wheelchairs , 2005, Journal of the American Geriatrics Society.

[13]  R. Magill Motor learning and control : concepts and applications , 2004 .

[14]  Lucas H V van der Woude,et al.  Return to Work After Spinal Cord Injury: Is It Related to Wheelchair Capacity at Discharge from Clinical Rehabilitation? , 2009, American journal of physical medicine & rehabilitation.

[15]  Joanne Yip,et al.  Development and content validation of the Wheelchair Use Confidence Scale: a mixed-methods study , 2011, Disability and rehabilitation. Assistive technology.

[16]  Asuman Öztürk,et al.  Effectiveness of a wheelchair skills training programme for community-living users of manual wheelchairs in Turkey: a randomized controlled trial , 2011, Clinical rehabilitation.

[17]  Claudine Auger,et al.  Issues for the selection of wheelchair-specific activity and participation outcome measures: a review. , 2008, Archives of physical medicine and rehabilitation.

[18]  J. Bussmann,et al.  Evidence of a logarithmic relationship between motor capacity and actual performance in daily life of the paretic arm following stroke. , 2009, Journal of rehabilitation medicine.

[19]  T. Shakespeare,et al.  Editorial , 2011, Disability and rehabilitation.

[20]  Krista L Best,et al.  Wheelchair skills training for community-based manual wheelchair users: a randomized controlled trial. , 2005, Archives of physical medicine and rehabilitation.

[21]  R Lee Kirby,et al.  Ambulation of people with lower-limb amputations: relationship between capacity and performance measures. , 2010, Archives of physical medicine and rehabilitation.