[show abstract][hide abstract] ABSTRACT: Objective: To evaluate the measurement properties of the Wheelchair Use Confidence Scale for manual wheelchair users version 2.1 (WheelCon-M 2.1). Design: Cohort study. Participants: Volunteer sample of 83 community-dwelling, experienced manual wheelchair users. Methods: Participants completed the WheelCon-M 2.1 twice to assess retest reliability. Validity was assessed by evaluating hypothesized relationships between the WheelCon-M 2.1 and relevant variables. Responsiveness was assessed using the standard error of measurement (SEM) and smallest real difference (SRD). Results: The median (interquartile range) WheelCon-M 2.1 score was 84.6 (71.3-92.0) of a possible 0-100. The one-week retest intraclass correlation coefficient was 0.84 with 95% bias-corrected and accelerated confidence intervals of 0.77-0.90. Cronbach's alpha was 0.92. Correlations ranging from rs = -0.19 (p = 0.780) to rs = 0.58 (p < 0.001) were found between the WheelCon-M 2.1 and other relevant outcome measures with all correlations being statistically significant except for age (p = 0.780) and social support (p = 0.057). A statistically significant difference was not found between the sexes (p = 0.140). The SEM and SRM were 5.9 and 16.4, respectively. Conclusions: WheelCon-M 2.1 has high internal consistency, strong retest reliability, and support for concurrent validity, construct validity and responsiveness. This new test holds promise as a clinical and research tool.
Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 11/2012; · 1.88 Impact Factor
[show abstract][hide abstract] ABSTRACT: Rushton PW, Kirby RL, Miller WC. Manual wheelchair skills: objective testing versus subjective questionnaire. 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.
Archives of physical medicine and rehabilitation 06/2012; · 2.18 Impact Factor
[show abstract][hide abstract] ABSTRACT: Wheelchair skills are not typically provided when a child gets a new wheelchair. The purpose of this prospective pilot study was to determine the effectiveness of a two-day modified Wheelchair Skills Programme 3.2 for children.
Six children (ages 6-19 years) with spinal cord injuries or spina bifida were invited to participate in a two-day wheelchair skills programme provided on subsequent Saturdays. Children were tested before and after training using a modified Wheelchair Skills Test 3.2. To assess for the effect of the programme on participation, the Activity Skills for Kids was used before and one month after training. For a more qualitative reflection, an Impact Questionnaire was given at four months post-training.
There was a significant (14%) increase in skills based on the Wheelchair Skills Test 3.2. No change in participation was measured with the Activity Skills for Kids. The Impact Questionnaire suggests the skill training allowed participants to do more, with less pain and fatigue post-training.
A two-day wheelchair skills programme can potentially improve skill level in children with spinal cord injuries or spina bifida.
Australian Occupational Therapy Journal 02/2012; 59(1):2-9. · 0.72 Impact Factor
[show abstract][hide abstract] ABSTRACT: Confidence in one's ability to perform a given task can be a stronger predictor of performance than skill itself. There are currently no measures to assess confidence with manual wheelchair use. The objective of this study was to develop and assess the content validity of the Wheelchair Use Confidence Scale (WheelCon-M).
A two-phase mixed-methods design was used. Semi-structured interviews were conducted to generate items, followed by a Delphi survey for item selection. Persons who use a wheelchair, health care professionals, and researchers participated in both phases of the study.
An 84-item WheelCon-M was developed based on the qualitative data. After the Delphi survey, a final 62-item WheelCon-M was composed of the following six areas (number of items per area): Negotiating the Physical Environment (33 items), Activities Performed using a Manual Wheelchair (11 items), Knowledge and Problem Solving (6 items), Advocacy (4 items), Managing Social Situations (5 items) and Managing Emotions (3 items).
This article reports the development and content validation of the WheelCon-M. As a scale to measure confidence with wheelchair use was not available prior to this work, clinicians now have a method of identifying individuals who have low confidence with wheelchair use.
Disability and rehabilitation. Assistive technology 01/2011; 6(1):57-66.
[show abstract][hide abstract] ABSTRACT: Cross-sectional.
To describe self-identified indoor and outdoor wheelchair-oriented participation outcomes and to report satisfaction with the identified outcomes by people with spinal cord injury (SCI).
Vancouver, British Columbia.
Participation outcomes were identified using the Wheelchair Outcome Measure and classified using the International Classification of Functioning, Disability, and Health (ICF).
The average age of the 51 community-dwelling subjects with SCI was 43.7(+/-10.7) years. Of them, 84% were men, 64% had tetraplegia and 66% used a manual wheelchair. There were 258 indoor and 257 outdoor participation outcomes identified by this sample with most outcomes falling into the 'community, social, and civil life' (36.5%), 'domestic life' (23.7%) and 'mobility' (18%) domains of the ICF. All domains had a mean satisfaction score of 7.1/10 or greater except for the indoor 'mobility' domain that had a mean satisfaction score of 6.1/10. Satisfaction scores with performance of the specific participation outcomes ranged from high (10/10) to low (2/10) with most scores falling above 7/10.
Community-dwelling people with SCI commonly engage in wheelchair-oriented participation outcomes related to 'community, social, and civil life', 'domestic life' and 'mobility' and tend to be satisfied with their performance of these participation outcomes. This information is useful for clinicians and may help to guide assessment and intervention.
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to identify factors that predict an individual's subjective quality of life (QoL) after having a lower limb amputation.
Cross-sectional descriptive study design.
A total of 415 unilateral, above knee (27.0%) and below knee (73.0%) amputees with an average age of 61.9 years (SD = 15.7) who had lost their limb related to vascular (53.0%) or non-vascular (47.0%) etiology.
Medical chart review, questionnaires (Frenchay Activities Index, Interpersonal Support Evaluation List, the Center for Epidemiology Studies - Depression scale, Prosthetic Evaluation Questionnaire mobility subscale, and the Activities-specific Balance Confidence Scale) and a QoL Visual Analogue Scale were assessed using multiple linear regression analysis.
The analysis revealed seven significant factors (depression, perceived prosthetic mobility, social support, comorbidity, prosthesis problems, age and social activity participation) as predictors of subjects' perceived QoL. Depression explained 30% of the variation, while the full model explained 42% of the variation.
Several modifiable characteristics influence QoL after lower limb amputation including depression and participation in daily living. This finding suggests the importance of addressing individuals' affective status to regain or maintain QoL.
Prosthetics & Orthotics International 07/2008; 32(2):231-43. · 0.56 Impact Factor