Role of Wheelchairs and Wheelchairs Assessments: A review (original) (raw)
Related papers
Wheelchair Functional Outcomes Measures & Functioning Everyday with a Wheelchair Tools
2006
The trend of increasing consumer needs, demands for wheelchair seating and mobility services, technological improvements, and lack of sufficient funding and policies for many consumers has made it necessary for practitioners and researchers to provide evidence that wheeled mobility and seating interventions are effective. Outcomes data provides a means for consumers to measure the effectiveness of technology in meeting their needs, assist providers in justifying their assistive technology recommendations and efficacy of their service delivery program, and allow payers and insurers to ensure that effective services were purchased. Therefore, to provide the necessary data, valid and reliable outcomes measurement tools that specifically measure consumer-generated functional outcomes of seating-mobility interventions must be available.
Factors Associated with Change in Functional Performance among Wheelchair Users
Factors Associated with Change in Functional Performance among Wheelchair Users, 2019
Objective: The main objective of this study was to explore demographics, wheelchair characteristics, and functional status indicators associated with changes in perceptions and functional performance of wheelchair users. Method: Nineteen wheelchair users were selected for this exploratory study. Utilizing Exhaustive Chi-Squared Automatic Interaction Detector (CHAID) analysis, seven models were generated to examine specific demographics, wheelchair characteristics, and functional status indicators associated with pretest to posttest change scores in perceptions and performance of everyday tasks over time of three target variables. Validation of the models generated by Exhaustive CHAID analyses was conducted through the n-fold cross-validation procedure. The Functioning Everyday with a Wheelchair (FEW), the FEW-Capacity (FEW-C), and the FEW-Performance (FEW-P) were the measures used in this study. Results: The means for the change score were larger for the FEW (1.08 ± 0.59) followed by the FEW-C (0.69 ± 0.63), and then the FEW-P (0.33 ± 0.45). Most of the factors identified in each model were derived from the pretest. Our study explored factors that were significantly associated with change scores of the FEW tools. Independence, number of physical assists, safety, and tasks related to Outdoor Mobility at pretest were the functional status indicators found to be of greatest importance and significantly associated with changes in perceptions and performance of everyday tasks over time in our models. For all analyses, the values of the Risk Estimate for the Risk Statistics and Cross-validation were close with relatively small differences, suggesting strong and reasonable confidence in the validity of the seven models. Conclusion: This study may suggest specific focus areas for assessment and intervention and may highlight the importance of some factors that influence changes in functional performance among clients who have been referred for, and prescribed, a wheeled mobility device.
Measurement properties of the wheelchair outcome measure in individuals with spinal cord injury
Spinal Cord, 2011
One-week retest methodological study. To assess the reliability and validity of the wheelchair outcome measure (WhOM) in a sample of individuals with spinal cord injury (SCI). Vancouver, British Columbia, Canada. The WhOM measures the impact of wheelchair interventions on a user's self-selected participation outcomes. The WhOM was administered to 50 participants on two occasions by the same rater, 1 week apart, to assess test-retest reliability. To determine inter-rater reliability, the WhOM was administered a third time approximately 72 h later by a different rater. Validity was evaluated by correlating scores from the WhOM with scores from the Assessment of Life Habits (LIFE-H). The test-retest intraclass correlation coefficients (ICC(2, 2)) for the WhOM satisfaction (Sat) and WhOM importance (Impt) × Sat scores were 0.83 (95% confidence interval (CI), 0.72-0.90) and 0.88 (95% CI, 0.79-0.93), respectively. The inter-rater ICC for the WhOM Sat and WhOM Impt × Sat scores were 0.91 (95% CI, 0.85-0.95) and 0.90 (95% CI, 0.83-0.94), respectively. As hypothesized, most scores on the WhOM were fair to moderate (r=0.3-0.5) and positively correlated with scores on the LIFE-H. The WhOM is a new outcome measure that demonstrates good reliability and validity among individuals with SCI. It is designed to assist wheelchair users identify and evaluate the impact of wheelchair interventions on participation level outcomes. The WhOM may be applicable for clinical- or research-oriented purposes.
Functional Assessment of Wheeled Mobility and Seating Interventions: Relationship of Self-Report and Performance-Based Assessments, 2019
The main objective of this study was to investigate associations, concordance and differences among self-report and performance-based measures, and reveal new factors associated with changes in wheelchair function. The Functioning Every day with a Wheelchair (FEW); a self-report measure, the FEW-Capacity (FEW-C); a performance-based measure for the clinic, and the FEW-Performance (FEW-P) that measures clients’ skills in the home were the measures used in this study. Relevant literature yielded few studies that examined the associations and concordance between subjective and objective methods of assessment with wheelchair users. We conducted secondary analyses of data collected by Mills et al. (2002) and Schmeler (2005), in which participants were assessed with their current wheelchairs at pretest, and later at posttest after they received their new wheelchairs. The strength of the associations varied by time, item, and environment, and there was a stronger association between the three tools at the pretest when compared with the posttest, perhaps due to the familiarity of their current wheeled mobility device and their desire for a new wheelchair. Exhaustive CHAID analysis revealed new factors that were significantly associated with pretest to posttest changes in wheelchair function and should therefore be assessed at pretest and targeted for intervention, namely, independence, number of physical assists, safety, and tasks related to Outdoor Mobility at pretest. Furthermore, for total scores, at pretest, there was no significant difference between the FEW-C and the FEW-P, whereas, at posttest, the Clinic total safety and quality scores were significantly better than the Home scores. We also found that the FEW-C was more concordant with the FEW-P compared to the FEW; therefore, clinicians may get a more accurate estimation of performance in the home from a clinic assessment compared to self-report. Clinically, the FEW tools provide complementary data which can contribute to clinical and research assessments of clients’ everyday functioning with their wheelchairs.
Development of a functional assessment measure for manual wheelchair users
The Journal of Rehabilitation Research and Development, 2003
This investigation developed the Wheelchair Users Functional Assessment (WUFA © ). Because no functional outcome tools exist that include many of the daily activities that are needed to be independent by individuals using manual wheelchairs, development of an appropriate tool was deemed important. Although the Functional Independence Measure (FIM™) can be used to assess disability in those using a wheelchair, it only measures some aspects of basic activities of daily living (ADLs) and does not measure community independence. Therefore, both basic activities and community activities were included in the new tool. A panel of six rehabilitation experts, with input from manual wheelchair users, determined content of the instrument. The resulting WUFA scale includes 13 items. Interrater reliability and stability were established with the calculation of an intraclass correlation coefficient (ICC). ICC for interrater reliability was 0.96 and ICC for stability was 0.78. Further analysis was performed on the internal consistency of the 13-item tool using a sample of 101 tested subjects. This analysis was done using a Cronbach's Alpha. Results indicated excellent internal consistency of the 13 items. The standardized coefficient alpha was 0.96. The WUFA was shown to have content validity, promising interrater reliability and stability, and good internal consistency. Further research is warranted to determine the tool's sensitivity and capability to discriminate between levels of functional independence. Abbreviations: ADL = activity of daily living, CUE = Capabilities of Upper Extremity, CVA = cerebral vascular accident, ICC = intraclass correlation coefficient, FIM = Functional Independence Measure, MBI = modified Barthel Index, MWCU = manual wheelchair users, QIF = Quadriplegia Index of Function, SCI = spinal cord injury, SCIM = Spinal Cord Independence Measure, WC-PFP = Wheelchair Physical Functional Performance, WST = Wheelchair Skills Test, WUFA © = Wheelchair Users Functional Assessment.
Association of Self-Report and Performance-Based Instruments to Measure Functional Performance among Wheelchair Users, 2019
Objective: The main objective of this study was to investigate associations of self-report and performance-based measures of functional performance for wheelchair users. Method: The Functioning Everyday with a Wheelchair (FEW); a self-report measure, the FEW-Capacity (FEW-C); a performance-based measure for the clinic, and the FEW-Performance (FEW-P); a performance-based measure that measures clients’ skills in the home were the measures used in this study. The current study examines the associations among the different methods used with the FEW, FEW-C and FEW-P at pretest when participants used their customary wheel chairs and post test when participants used their new wheelchairs. Results: Our hypothesis that there would be a stronger association between the FEW, FEW-C, and FEW-P at the pretest than the posttest due to the familiarity with the wheeled mobility device was partially confirmed. Overall, the relationships among the self-report (FEW) and the performance-based (FEW-C, FEW-P) total independence scores were significantly associated at both pretest and posttest as were the relationships between the two performance-based tools. However, these significant relationships were stronger at the pretest compared to the posttest. Conclusion: Our hypothesis that there would be a stronger association between the FEW, FEW-C and FEW-P at the pretest when compared with the posttest was accepted for the total scores but was only partially confirmed for the individual items of these tools. Our findings indicate that both methods (self-report and performance-based) can yield useful information, may have potential roles in clinical and research settings, and may have complementary relationships.
Functioning Everyday with a Wheelchair (FEW) Tools: A review
Functioning Everyday with a Wheelchair (FEW) Tools: A review, 2018
There is currently a lack of comprehensive outcome measures that focus on everyday functioning with a wheelchair.Most of the current measures don’t address the quality of functional performance or provide individual scores for independence and safety for both manual and power wheelchair users. Furthermore, these measures do not fully represent all the important tasks wheelchair users identified as important to perform in a seating-mobility device such as comfort needs, reaching, transfers, and transportation. In response to the need for more comprehensive outcome measures, the FEW tools have been developed and proved to be comprehensive, reliable, valid, and useful.
Archives of Physical Medicine and Rehabilitation, 2004
Kirby RL, Dupuis DJ, MacPhee AH, Coolen AL, Smith C, Best KL, Newton AM, Mountain AD, MacLeod DA, Bonaparte JP. The Wheelchair Skills Test (version 2.4): measurement properties. Arch Phys Med Rehabil 2004;85:794-804. Objective: To evaluate the measurement properties of the Wheelchair Skills Test (WST), version 2.4. Design: Cohort study. Setting: Rehabilitation center. Participants: A total of 298 subjects (169 wheelchair users, 129 able-bodied subjects) ranging in age from 17 to 88 years.
Concordance of Self-Report and Performance-Based Measures of Function and Differences between Clinic and Home among Wheelchair Users, 2019
Objective: The main objective of this study was to investigate concordance and differences among self-report and performance-based measures for wheelchair users. Method: The Functioning Everyday with a Wheelchair (FEW); a self-report measure, the FEW-Capacity (FEW-C); a performance-based measure for the clinic and the FEW-Performance (FEW-P) that measures clients’ skills in the home were the measures used in this study. We examined the concordance of the FEW and the FEW-C with the FEW-P as the criterion measure, and investigated the differences between the FEW-C and the FEW-P at pretest and posttest following the provision of a new wheeled mobility and seating device. Results: Our results suggested that the FEW-C was most concordant with the FEW-P for majority of the items compared to the FEW. At both pretest and posttest, for most of the tasks, the FEW-C and FEW-P were comparable suggesting that the environment may have a neutral effect. However, at posttest, the clients’ safety scores for the outdoor mobility task and the clients’ quality scores for the Personal Care task improved significantly suggesting that the standard supportive environment of the clinic may have enabling effect on activity performance. Conclusion: Clinically, rehabilitation clinicians may get a more accurate estimation of functional performance in the home from a clinic assessment, and they are cautioned that the inclusion of self-report assessment and data obtained from clients’ perceptions may be discrepant with actual performance. We also concluded that the impact of the environment on activity performance of wheelchair users can be neutral or enabling depending on time of assessment and tasks being assessed.