Tool for assessing mobility in wheelchair-dependent paraplegics

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Tool Description

  • Used to quantify the mobility of individuals with SCI who use a wheelchair.
  • Assesses motor tasks such as: moving from lying to sitting; completing a horizontal transfer; completing a vertical transfer; pushing a wheelchair on flat ground; pushing a wheelchair up/down ramps; and negotiating curbs in a wheelchair.

ICF Domain:

Activity – subcategory: Mobility.

Number of Items:

6

Brief Instructions for Administration & Scoring

Administration:

  • Clinician-administered; performance based assessment.
  • For each task, subjects are scored on a six-point scale with 6 representing complete independence, and 1 representing total assistance.  Patients must perform the tasks in the following order: Task 1) supine to long sitting; Task 2) horizontal transfer; Task 3) vertical transfer; Task 4) push on flat; Task 5) push on ramp; Task 6) negotiate curbs. For tasks 2 through 6, the patients are allowed three attempts with the best score recorded.  If a task is not attempted, ‘not applicable’ is recorded.

Equipment:

  • A 25 meter hallway
  • Cones
  • A 15 meter ramp
  • Curbs 2.5 cm and 15 cm high

Scoring:

  • The scores for each task are not meant to be added together to give an overall score. Rather, each task is given a score and interpretation is in relation to that specific task.
  • For each task patients are scored on a six-point scale (takes into account assistance and performance time)

Interpretability

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

  • Higher scores indicate greater independence.
  • No norms or cut scores for the SCI population are available at this time.

Languages:

n/a

Training Required:

No formal training required, but a trained physiotherapist should be administering this.

Availability:

See the ‘How-to use’ page of this tool.

Clinical Considerations

  • The results of the assessment tool summarize the basic level of wheelchair mobility of patients in a manner that is readily understood by other professionals.
  • The tool was designed specifically for individuals with paraplegia who use a manual wheelchair.

Measurement Property Summary

# of studies reporting psychometric properties: 1

Reliability:

  • Inter-rater reliability was measured by examining % agreement between 2 raters.
  • When the data from the six tasks were pooled, the two therapists’ scores were in perfect agreement 82% of the time, within one grade 17% of the time, within two grades 2% of the time and never differed by three or more grades.

[Harvey et al. 1998]

Validity:

No values were reported for the validity of the Tool for assessing mobility in wheelchair-dependent paraplegics for the SCI population.

Responsiveness:

No values were reported for the responsiveness of the Tool for assessing mobility in wheelchair-dependent paraplegics for the SCI population.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the Tool for assessing mobility in wheelchair-dependent paraplegics for the SCI population.

Reviewer

Dr. William Miller, Matthew Querée

Date Last Updated:

Feb 1, 2017

Download the measure

Download Worksheet:

Worksheet Document

Video

n/a

Scoring

Patients are assessed on their ability to perform six different tasks. For each task patients are scored on a six-point scale, with 6 representing the best score and 1 the worst. Patients must perform the tasks in the same order, as set out below. With tasks number 2 and 6, the patient may have three attempts with the best score recorded. The scores for each task were not designed to be added or combined in any way. If a test is not attempted, `not applicable should be recorded, not a score of 1. For the tasks where assistance is quantified the following definitions apply:

Total assistance. A situation where the patient provides less than 25% of the effort required to complete the task and the clinician provides the remaining effort.

Maximal assistance. A situation where the patient provides between 25% and 49% of the effort required to complete the task and the clinician provides the remaining effort.

Moderate assistance. A situation where the patient provides between 50% and 74% of the effort required to complete the task and the clinician provides the remaining effort.

Minimal assistance. A situation where the patient provides between 75% and 99% of the effort required to complete the task and the clinician provides the remaining effort.

Supervision. A situation where the patient provides 100% of the effort to complete the task and the clinician provides either verbal prompts or supervision. However, the clinician does not provide any physical assistance.

Independent. A situation where the patient provides 100% of the effort required to complete the task and the patient does not require any supervision or verbal prompts.

Equipment Needed

  • A 25 meter hallway
  • Cones
  • A 15 meter ramp
  • Curbs 2.5 cm and 15 cm high

Tools for assessing mobility in wheelchair-dependent paraplegics:

Harvey LA, Batty J, Fahey A. Reliability of a tool for assessing mobility in wheelchair-dependent paraplegics. Spinal Cord 1998;36:427-431.
http://www.ncbi.nlm.nih.gov/pubmed/9648200