Test-Retest Reliability and Cross Validation of the Functioning Everyday With a Wheelchair Instrument
ABSTRACT The purpose of this study was to establish the test-retest reliability and content validity of an outcomes tool designed to measure the effectiveness of seating-mobility interventions on the functional performance of individuals who use wheelchairs or scooters as their primary seating-mobility device. The instrument, Functioning Everyday With a Wheelchair (FEW), is a questionnaire designed to measure perceived user function related to wheelchair/scooter use. Using consumer-generated items, FEW Beta Version 1.0 was developed and test-retest reliability was established. Cross-validation of FEW Beta Version 1.0 was then carried out with five samples of seating-mobility users to establish content validity. Based on the content validity study, FEW Version 2.0 was developed and administered to seating-mobility consumers to examine its test-retest reliability. FEW Beta Version 1.0 yielded an intraclass correlation coefficient (ICC) Model (3,k) of .92, p < .001, and the content validity results revealed that FEW Beta Version 1.0 captured 55% of seating-mobility goals reported by consumers across five samples. FEW Version 2.0 yielded ICC(3,k) = .86, p < .001, and captured 98.5% of consumers' seating-mobility goals. The cross-validation study identified new categories of seating-mobility goals for inclusion in FEW Version 2.0, and the content validity of FEW Version 2.0 was confirmed. FEW Beta Version 1.0 and FEW Version 2.0 were highly stable in their measurement of participants' seating-mobility goals over a 1-week interval.
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ABSTRACT: The purpose of this paper is to explain the development, methodology, and implementation of an assistive technology (AT) service delivery protocol using a telerehabilitation consultation model for evaluation of remote wheelchair prescriptions. The provision of wheeled mobility and seating interventions can be complex when considering people with intricate seating and positioning needs, environmental factors, and wide array of product interventions. The availability of qualified practitioners with specialty expertise in this area is limited, especially outside of urban areas. Therefore, people are potentially isolated from rehabilitation services due to geography or physical limitations. A repeated measure study design is used to evaluate the service delivery protocol measured by the effectiveness of wheeled mobility and seating interventions provided in a remote location by a generalist occupational and/or physical therapy practitioner with consultation from an expert therapist via interactive teleconferencing. Effectiveness is measured by magnitude of change and scored by pre and post scores of the Functioning Everyday with a Wheelchair (FEW) outcome measure tool. Two model programs have been specified and are currently implementing the service delivery protocol. The live interaction has enabled remote therapists the ability to exchange personal and health information to experts in the field from an urban facility. The impact of this service delivery protocol will be augmented as it is to be launched and replicated in three additional sites. Telerehabilitation is a new field that can only be measured by its long-term impact; however, its success can be looked at by its development and implementation into everyday clinical service delivery.Telemedicine and e-Health 12/2008; 14(9):932-8. · 1.40 Impact Factor
- Archives of Physical Medicine and Rehabilitation - ARCH PHYS MED REHABIL. 01/2011; 92(10):1694-1694.
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ABSTRACT: Nearly 3 million people in the Unites States utilize a wheelchair for mobility. Yet, there is no standardized assessment or procurement process for wheelchair provision. Thus, practitioners have limited guidance in the essential elements of a wheelchair assessment. End users may have no or limited experience in determining the best choice of wheelchairs to meet their needs and often rely on the knowledge of the practitioner in the decision-making process of wheelchair selection. The author explored the current state of practice and the essential elements in the wheelchair assessment and procurement process. Obtaining the correct wheelchair is a complex process, involving the client, family, practitioners, suppliers, manufacturers, policy makers and insurers. This study utilized a qualitative research approach using Participatory Action Research (PAR) and a Delphi consensus approach to garner input from 155 individuals who have experience in or with wheelchair assessments. Participants in this study included representation from wheelchair manufacturers, suppliers, educators, occupational and physical therapists, end users, policy makers, and government affairs personnel. The findings of this study suggest that the wheelchair assessment include a wide range of elements, be client specific, and reflect a client-centered process. INTRODUCTION / STATEMENT OF THE PROBLEM According to the U.S. Census Bureau's Survey of Income and Program Participation (SIPP), an estimated 2.8 million. Americans residing outside of institutions utilize wheelchairs as an assistive technology device for mobility impairments. 1 There are 51 million people with disabilities; people who use mobility devices make up 1% of the population aged 6 and older. 1 Obtaining the correct wheelchair is a complex process, and if one is unable to obtain the correct wheelchair, it may lead to untoward consequences of injury, contribute to activity limitations, and may impact one's ability to be employed. Unfortunately, there is no consistent measurement standard or procedure for the practitioner who prescribes a mobility device. While the potential benefit of assistive technology (AT) is known to consumers, caregivers, health-care practitioners, and policy makers, there is limited empirical evidence to validate the benefit and efficacy of wheelchair provision. 2,3 The AT community would benefit from a developed standard of practice for wheelchair assessment because the potential benefit of wheeled mobility devices cannot be determined without an assessment of a client's functional and medical status and desired goals. 4-9