Evaluation of manual wheelchair skills: is objective testing necessary or would subjective estimates suffice?
OBJECTIVE
To test the hypothesis that subjective estimates of the ability to perform manual wheelchair skills, by wheelchair users and the therapists working with them, accurately reflect the results of objective testing.


METHODS
Within-subject comparisons.


METHODS
Kinesiologic laboratory in a rehabilitation center.


METHODS
Twenty-one wheelchair users and their therapists.


METHODS
The wheelchair users and their therapists subjectively estimated how the wheelchair users would perform manual wheelchair skills, followed by an objective assessment.


METHODS
Wheelchair Skills Test (WST, version 2.4), a set of 50 standardized skills.


RESULTS
The Spearman correlation coefficients between the total objective and subjective scores were.95 for the wheelchair users and.75 for the therapists. The mean difference between the total objective and subjective scores was statistically significant (P=.0002) for the wheelchair users (who overestimated their abilities by an average of 17.9%). The percentage concordance between subjective and objective scores for individual skills ranged from 57.1% to 100% for the wheelchair users and 50% to 100% for the therapists, with 25% and 35% of skills, respectively, for which there were no statistically significant associations (at a Bonferroni-adjusted alpha level of.001) between the objective and subjective scores. The skills that were misestimated by both were moving the armrests away, reaching a high object, transferring out of and into the wheelchair, folding the wheelchair, incline ascent, negotiation of gravel and irregular surfaces, and small curb ascent.


CONCLUSIONS
Although subjective ratings by wheelchair users and their therapists provide excellent and good estimates respectively of overall manual wheelchair abilities, objective testing should be performed when accurate assessments of many specific manual wheelchair skills are required.
Newton
Allison M
AM
Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada.
Kirby
R Lee
RL
Macphee
Angela H
AH
Dupuis
Debbie J
DJ
Macleod
Donald A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009069:Movement Disorders / Q000503:physiopathology* / Q000534:rehabilitation; D018709:Statistics, Nonparametric; D013647:Task Performance and Analysis; D014910:Wheelchairs