Krista L. Best

Comparison between performance with a pushrim-activated power-assisted wheelchair and a manual wheelchair on the Wheelchair Skills Test.

Purpose. To test the hypothesis that people using a pushrim-activated power-assisted wheelchair (PAPAW) can accomplish a wider range of wheelchair skills than when using a manual wheelchair (MWC). Methods. We studied 30 able-bodied participants, using within-participant comparisons. Participants used a manual wheelchair equipped with both PAPAW and regular MWC rear wheels, and rear anti-tip devices (Arc-RADs) that permitted wheelie-like function. We trained participants to perform the wheelchair skills of the Wheelchair Skills Training Program (WSTP, Version 2.4). From the Wheelchair Skills Test (WST, Version 2.4), we calculated pass-fail success rates for the 50 individual skills and a total percentage WST score. Results. The mean (±SD) total WST scores were 89.3 (±7.0)% for the PAPAW and 88.8 (±8.4)% for the MWC, with a mean difference of 0.6 (±5.6)% (p = 0.59). Qualitative observations suggested that skills requiring a higher force on the pushrim (e.g., incline ascent) were performed more easily with the PAPAW, whereas skills requiring greater control of the wheelchair (e.g., wheelie-dependent skills) were performed more easily with the MWC. Conclusion. Overall wheelchair skill performance with the PAPAW is not superior to that when using the MWC. The PAPAW may be helpful for specific skills that require more wheel torque, but the additional torque appears to be disadvantageous when performing skills that require greater control.

Protocol for the development and pilot evaluation of a smartphone-delivered peer physical activity counselling program for individuals with spinal cord injury. (Preprint)

Background Leisure-time physical activity (LTPA) is a critical component of a healthy lifestyle for individuals with spinal cord injury (SCI). However, most individuals are not sufficiently active to accrue health benefits. The Active Living Lifestyles program for individuals with SCI who use manual wheelchairs (ALLWheel) targets important psychological factors that are associated with LTPA uptake and adherence while overcoming some barriers associated with participation restrictions. Objective The goal of the paper is to describe the protocol for the development and evaluation of the ALLWheel program for individuals with SCI who use manual wheelchairs. Methods The first three stages of the Medical Research Council framework for developing and evaluating complex interventions (ie, preclinical, modeling, exploratory) are described. The preclinical phase will consist of scoping and systematic reviews and review of theory. The intervention will be modeled by expert opinions and consensus through focus groups and Delphi surveys with individuals with SCI, clinicians, and community partners. Finally, the feasibility and potential influence of the ALLWheel program on LTPA and psychological outcomes will be evaluated. Results This project is funded by the Craig H Neilsen Foundation, the Fonds de Recherche du Québec–Santé, and the Canadian Disability Participation Project and is currently underway. Conclusions Using peer trainers and mobile phone technology may help to cultivate autonomy-supportive environments that also enhance self-efficacy. Following a framework for developing and evaluating a novel intervention that includes input from stakeholders at all stages will ensure the final product (ie, a replicable intervention) is desirable to knowledge users and ready for evaluation in a randomized controlled trial. If effective, the ALLWheel program has the potential to reach a large number of individuals with SCI to promote LTPA uptake and adherence. International Registered Report Identifier (IRRID) DERR1-10.2196/10798

Poster 148: The wheelchair skills test, version 2.4: measurement properties.1

Objective: To evaluate the measurement properties of the Wheelchair Skills Test (WST), Version 2.4. Design: Prospective, cohort. Setting: Rehabilitation center. Participants: 298 in all, 169 wheelchair users, and 129 able-bodied subjects, ranging in age from 17 to 88 years. Interventions: Each participant attempted the 50 skills of the WST 2.4. Main Outcome Measures: Reliability was determined on a subset of 20 wheelchair users. We assessed construct validity by evaluating whether the WST detected expected changes and concurrent validity by seeing how well total WST scores correlated with criterion measures. Results: The mean time ± SD taken to administer the WST was 27.0±9.3 minutes. There were no serious adverse incidents. For the test-retest and intra- and interrater reliabilities, the intraclass correlation coefficients for the total scores were .904, .959, and .968. For individual skills, the percentage concordance ranged from 73% to 100%. Regarding construct validity, there was a slight negative correlation between total WST score and age (r=−.434, P 21 days of experience scored higher than those with less experience (65.0% vs 59.6%, P=.01). Participants with stroke and related disorders had a mean score (55.0%±13.9%) that was significantly lower than those in other diagnostic categories (P<.05). Participants using conventional wheelchairs had lower scores than those in lightweight ones (66.4% vs 75.1%, P<.001). Regarding concurrent validity, correlations between total WST scores and the global assessments of the wheelchair users’ therapists and admission and discharge FIM scores were .394, .38, and .31. Conclusions: The WST 2.4 is practical and safe and has very good to excellent measurement properties. Further study will be needed to determine its usefulness in a variety of clinical settings.