Wheelchair Circuit (WC)

Download Clinical Summary PDF

Tool Description

  • Assesses manual wheelchair mobility (i.e. skill and performance).
  • Tasks cover 3 aspects of mobility:
    1) Tempo (tasks = figure-of-8 shape and sprint)
    2) Technical skill (tasks = crossing a doorstep, mounting a platform, and transferring)
    3) Physical capacity (tasks = wheelchair propulsion and ascending slopes).

ICF Domain:

Activity – subcategory: Mobility.

Number of Items:

9

Brief Instructions for Administration & Scoring

Administration:

  • Clinician-administered; performance-based measure
  • Consists of 9 standardized ADL tasks relating mainly to 3 aspects of mobility – tempo, technical skills and physical capacity.
  • During each of the following tasks, performance time, distance or successful completion are recorded.
  • There is a resting time of 2 minutes between each task.

Equipment:

  • An adjustable mat
  • Treadmill (with 3% and 6% grade)
  • HR monitor
  • Stopwatch
  • 0.10 m platform on floor
  • Wood doorstep height 0.4 m
  • Open space
  • 15 m corridor.

Scoring:

  • Separate scores for ability (ordinal scale); performance time (seconds); and physical strain (formula using HR data) are calculated.

Interpretability

MCID: not established in SCI
SEM & MDC:
SEM and MDC values (calculated from data in Kilkens et al. 2002) for performance time and peak heart rates during Wheelchair circuit tasks

Performance Time: Task

SEM

MDC

Figure-of-8 shape

1.5

4.1

Crossing doorstep

2.2

6.1

Mounting platform

2.3

6.2

Sprint

0.6

1.5

Transfer

12.2

33.8

Peak Heart Rate:

Task

Figure-of-8 shape

6.8

18.9

Crossing doorstep

6.4

17.7

Mounting platform

7.7

21.3

Sprint

7.5

20.9

Walking

4.4

12.2

3% slope

9.1

25.3

6% slope

6.7

18.5

Wheelchair driving

6.9

19.2

Transfer

9.2

25.7

  • No normative data is available for the SCI population
  • Published data for the SCI population is available for comparison (see the Interpretability section of the Study Details sheet).

Languages:

n/a

Training Required:

No training is mentioned by the authors, however experience in exercise testing is helpful.

Availability:

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

Clinical Considerations

  • The performance time and physical strain are useful to monitor progress once the individual achieves a maximal score on the ability score or if they have not demonstrated any change over repeated administrations.
  • The WC includes functional tasks developed specifically for the SCI population. However, the tasks are only relevant to manual wheelchair users. Some tasks may be too difficult / not suitable if individuals have medical complications or are older.
  • The Wheelchair Circuit consists of 9 observational tasks on mobility; this may cause significant patient and clinician burden.

Measurement Property Summary

# of studies reporting psychometric properties: 2

Reliability:

  • Intra-rater reliability is High for the total WC (ICC=0.98), and Moderate to High for both individual tasks (ICC=0.71-0.99) and for record peak heart rate during tasks (ICC=0.68-0.96).
  • Inter-rater reliability is High for the total WC (ICC=0.97), individual tasks (ICC=0.76-0.98) and record peak heart rate during tasks (ICC=0.82-0.99).

[Kilkens et al. 2002]

Validity:

  • Functional Independence Mobility (FIM) – mobility subscale score, peak power output and VO2 peak are all significantly correlated to total ability score and performance time score.

[Kilkens et al. 2004]

Responsiveness:

  • Standardized response mean between start of rehabilitation program and discharge is 0.6 for Ability score, 0.9 for Performance time score and 0.8 for Physical strain score.

[Kilkens et al. 2004]

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the WC for the SCI population.

Reviewer

Dr. William Miller, Matthew Querée

Date Last Updated:

July 26, 2016

Download the measure

Download Worksheet:

Worksheet Document

Video

n/a

Scoring

During each of the following tasks, performance time, distance or successful completion are recorded.

Equipment Needed

  • An adjustable mat
  • Treadmill (with 3% and 6% grade)
  • HR monitor
  • Stopwatch
  • 0.10 m platform on floor
  • Wood doorstep height 0.4 m
  • Open space
  • 15 m corridor.

WC:

Dallmeijer AJ, van der Woude LH, Hollander AP, van As HH. Physical performance during rehabilitation in persons with spinal cord injuries. Med Sci Sports Exerc 1999;31:1330-1335.
http://europepmc.org/abstract/MED/10487376

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

Janssen TW, van Oers CA, van der Woude LH, Hollander AP. Reliability of heart rate response to non-steady-state activities of daily living in men with spinal cord injuries. Scand J Rehabil Med 1994;26:71-78.
http://www.ncbi.nlm.nih.gov/pubmed/7939495

Kilkens OJ, Dallmeijer AJ, De Witte LP, Van Der Woude LH, Post MW. The Wheelchair Circuit: Construct validity and responsiveness of a test to assess manual wheelchair mobility in persons with spinal cord injury. Arch Phys Med Rehabil 2004;85:424-431.
http://www.ncbi.nlm.nih.gov/pubmed/15031828

Kilkens OJ, Post MW, van der Woude LH, Dallmeijer AJ, van den Heuvel WJ. The Wheelchair Circuit: reliability of a test to assess mobility in persons with spinal cord injuries. Arch Phys Med Rehabil 2002;83:1783-1788.
http://www.ncbi.nlm.nih.gov/pubmed/12474187