Manual Wheelchair Skills: Objective Testing Versus Subjective Questionnaire

Rushton PW, Kirby RL, Miller WC. Manual wheelchair skills: objective testing versus subjective questionnaire. Arch Phys Med Rehabil 2012;93:2313-8. 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 rho=.89 (P=.000) for capacity and rho=.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.