Wheelchair Skills Test (WST)

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Tool Description

  • Used to objectively evaluate manual wheelchair skills and safety.
  • There are 5 versions, including manual wheelchairs, powered wheelchairs and scooters, for both wheelchair users and caregivers (excepting scooters).
  • Existing wheelchair tests (Harvey et al. 1998) do not include the level of wheelchair skills required for daily functioning. The latest version of the WST is 4.2; prior versions include 1.0, 2.4, and 3.2.

ICF Domain:

Activity – subcategory: Mobility.

Number of Items:

32

Brief Instructions for Administration & Scoring

Administration:

  • Clinician-administered; performance-based measure
  • The revised WST 2.4 includes 50 skills in 10 areas (brakes, armrests, footrests, rolling, turning, reaching, transfers, fold/open, obstacles, and wheelie).
  • The individual is required to use a manual wheelchair
  • 2 attempts, with a rest, are permitted to complete the task.

Equipment:

  • A standardized wheelchair circuit or access to a variety of environmental obstacles, although test developers now advocate use of existing barriers in the natural environment (ex. ramps, curbs, potholes, etc.)

Scoring:

  • Scoring is on a pass-fail basis (pass=2, pass with difficulty=1, fail=0, NP= not possible, TE=testing error) with an additional goal attainment score (GAS), for which the clinician indicates whether or not the skill is a reasonable goal for the individual case (N/G=not a goal).

Interpretability

MCID: not established for SCI
SEM: not established for SCI
MDC: not established for SCI

  • No cut-points or normative data have been established for the SCI population
  • Published data for the SCI population is available for comparison (see Interpretability section in the Study Details sheet).

Languages:

n/a

Training Required:

The clinician requires test familiarization and a spotter is mandatory.

Link to WST Manual: http://www.wheelchairskillsprogram.ca/eng/testers.php

Link to WST Program Manual: http://www.wheelchairskillsprogram.ca/eng/trainers.php

Availability:

The WST manual, questions, and scoring form are available here http://www.wheelchairskillsprogram.ca/eng/

Clinical Considerations

  • The tasks cover a wide range of difficulty while remaining functional. It is a generic tool that can be used for several populations (e.g. SCI, amputees, stroke, musculoskeletal disorders, able-bodied) and it was developed using both inpatient and community dwelling samples.
  • The Wheelchair Skills Test is developed for manual wheelchair users, therefore, it may not be appropriate for all individuals with SCI.
  • The Wheelchair Skills Test typically takes 30 minutes to administer and the WST-Q takes 10 minutes.

Measurement Property Summary

# of studies reporting psychometric properties: 3

Reliability:

  • Test-retest reliability for the WST is Moderate (Spearman’s r=0.65).
  • Intra-rater reliability is High (0.96), as is inter-rater reliability (Spearman’s r=0.95).
  • Test-retest reliability is High for maximal velocity Vmax (ICC=0.94), spontaneous velocity Vspont (ICC=0.84) and slalom time Stime (ICC=0.88).
  • Inter-rater reliability is High for Vmax (ICC=0.92), Vspont (ICC=0.92) and Stime (ICC=0.95).

[Kirby et al. 2002,Pradon et al. 2012]

Validity:

  • Correlation of both the WST version 1 (Spearman’s r=0.40) and WST version 2 (Spearman’s r=0.54) is Moderate with the Occupational Therapists Global Assessment-Visual Analog Scale (VAS).
  • Correlation of the WST score is High with Vmax (Spearman’s r=0.72) and Stime (Spearman’s r=-0.75) and Moderate with Vspont (Spearman’s r=0.57).
  • WST total performance score is significantly correlated with wheeled distance per day (Pearson’s r=0.36) and age (Pearson’s r=-0.32).

[Kirby et al. 2002,Pradon et al. 2012, Lemay et al. 2011]

Responsiveness:

No values have been reported for the responsiveness of the WST for the SCI population at this time.

Floor/ceiling effect:

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

Reviewer

Dr. William Miller, Matthew Querée, Sharon Jang

Date Last Updated:

Feb 1, 2017

Download the measure

Download Worksheet:
Link to WST Forms: http://www.wheelchairskillsprogram.ca/eng/wspforms.php

Video

n/a

Scoring

n/a

Equipment Needed

WST:

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

Kirby RL, Swuste J, Dupuis DJ, MacLeod DA, Monroe R. The Wheelchair Skills Test: a pilot study of a new outcome measure. Arch Phys Med Rehabil 2002;83:10-18.
http://www.ncbi.nlm.nih.gov/pubmed/11782826

Pradon D, Pinsault N, Zory R, Routhier F. Could mobility performance measures be used to evaluate wheelchair skills? J Rehabil Med, 2012; 44:276-279.
http://www.ncbi.nlm.nih.gov/pubmed/22278048

Rushton PW, Kirby RL, Routhier F, Smith C. (2016) Measurement properties of the Wheelchair Skills Test – Questionnaire for powered wheelchair users, Disability and Rehabilitation: Assistive Technology, 11:5, 400-406, DOI: 10.3109/17483107.2014.984778.  http://www.ncbi.nlm.nih.gov/pubmed/25411057

Lemay V, Routhier F, Noreau L, Phang SH, Martin Ginis KA. Relationships between wheelchair skills, wheelchair mobility and level of injury in individuals with spinal cord injury. Spinal Cord (2011), 1–5. http://www.ncbi.nlm.nih.gov/pubmed/21931330

Hosseini SM, Oyster ML, Kirby RL, Harrington AL, Boninger ML. Manual Wheelchair Skills Capacity Predicts Quality of Life and Community Integration in Persons With Spinal Cord Injury. Arch Phys Med Rehabil Vol 93, December 2012; 2237-2243. http://www.ncbi.nlm.nih.gov/pubmed/22684049

Lindquist NJ, Loudon PE, Magis TF, Rispin JE, Kirby RL, Manns PJ. Reliability of the Performance and Safety Scores of the Wheelchair Skills Test Version 4.1 for Manual Wheelchair Users. Archives of Physical Medicine and Rehabilitation. 2010;91:1752-57. http://www.ncbi.nlm.nih.gov/pubmed/21044722

Mountain AD, Kirby RL, Smith C. The Wheelchair Skills Test, Version 2.4: Validity of an Algorithm-Based Questionnaire Version. Archives of Physical Medicine and Rehabilitation. 2004;85:416-23. http://www.ncbi.nlm.nih.gov/pubmed/15031827

Kirby RL., Dupuis DJ, MacPhee AH et al. The Wheelchair Skills Test (Version 2.4): Measurement Properties. Archives of Physical Medicine and Rehabilitation. 2004;85:794-804. http://www.ncbi.nlm.nih.gov/pubmed/15129405