title: Adapted manual wheelchair circuit: test-retest reliability and discriminative validity in persons with spinal cord injury.
abstract: OBJECTIVE
  To assess the test-retest reliability and discriminative validity of a 14-item manual wheelchair circuit adapted from previous research (AMWC).
  
  
  METHODS
  Two AMWC trials per subject completed within 15 days.
  
  
  METHODS
  Two clinical research and 3 rehabilitation centers.
  
  
  METHODS
  Convenience sample of individuals with spinal cord injury (N=50) from centers in the United States (n=38) and the Netherlands (n=12). Mean age ± SD was 46±13 years, and mean injury duration ± SD was 12±11 years. Fifteen had cervical injuries, and 42 were men.
  
  
  METHODS
  An existing 8-task manual wheelchair circuit was modified to remove the need for a wheelchair treadmill and expanded to 14 tasks to attenuate floor and ceiling effects: 5 original tasks-figure-of-8, .012-m doorstep crossing, .10-m platform, 15-m sprint, and making a level transfer; 3 modified tasks-3% and 6% ramp, and 3-minute overground wheeling; and 6 new tasks-.04-m doorstep crossing, propelling over artificial grass, opening/closing a door, 3% side slope, holding a wheelie for 10 seconds, and propelling in a wheelie.
  
  
  METHODS
  Reliability of the primary outcomes, sum ability score (sum of all tasks; 0-14 [no.]) and sum performance time (figure-of-8 + sprint + grass; 0-360 [s]), was determined by intraclass correlation coefficients (ICCs) for the whole sample and paraplegia (PP) and tetraplegia (TP) subsets. Independent t tests compared PP and TP trial 1 sum ability score and sum performance time.
  
  
  RESULTS
  Sum ability and sum performance time ICCs exceeded .90 for the full sample and the PP/TP subsets. Sum ability was higher for PP than TP (PP, 12.9±1.2; TP, 9.8±2.8; P<.00), and sum performance times were lower for PP than TP (20.0±4.0s vs 32.0±1.97s, P<.00).
  
  
  CONCLUSIONS
  AMWC primary outcomes, sum ability score and sum performance time, are reliable and discriminate between TP and PP.
authors.affiliation: Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA. r.cowan@miami.edu
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Cowan
authors.forename: Mark S
authors.initials: MS
authors.lastname: Nash
authors.forename: Sonja
authors.initials: S
authors.lastname: de Groot
authors.forename: Lucas H
authors.initials: LH
authors.lastname: van der Woude
mesh_terms: D000328:Adult; D016002:Discriminant Analysis; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010264:Paraplegia / Q000503:physiopathology* / Q000534:rehabilitation; D011597:Psychomotor Performance; D011782:Quadriplegia / Q000503:physiopathology* / Q000534:rehabilitation; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013647:Task Performance and Analysis; D014481:United States; D014910:Wheelchairs