• 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.

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.

ICF Domain

Activity – subcategory: Mobility.

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.

Number of Items

6 tasks

Equipment

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

Scoring

  • Each task performed is rated from 1 (Independent) to 6 (Total Assistance). The score also takes into account performance time.
  • Tasks 2 through 6 are scored using the best score out of up to 3 attempts. If a task is not attempted, ‘not applicable’ is recorded.
  • Task scores are reported separately.
  • 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.

Languages

n/a

Training Required

None mentioned by authors, however administration by a trained physiotherapist is preferred.

Availability

n/a – Instructions for use tell you what is required to perform the test.

Measurement Property Summary

# of studies reporting psychometric properties: 1

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.

Typical Values

Median (IQR) scores:

Task 1 – 6 (3.75 ± 6)

Task 2 – 6 (6 ± 6)

Task 3 – 3.5 (1 ± 6)

Task 4 – 5 (4.5 ± 5.25)

Task 5 – 5 (4.25 ± 5.0)

Task 6 – 3.5 (2 ± 5.25)

(Harvey et al. 1998; N=20 inpatients and outpatients; mixed injury types; median (IQR) time post-SCI = 9(2.5-18))

Reliability

Inter-rater reliability is High for the Tool for Assessing Mobility in Wheelchair-Dependent Paraplegics (Cohen’s Weighted Kappa=0.82-0.96).

When the data from the 6 tasks were compared, the 2 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; N=20 inpatients and outpatients; mixed injury types; median (IQR) time post-SCI = 9(2.5-18))

Number of studies reporting reliability data: 1

Number of studies reporting reliability data: 1

Number of studies reporting validity data: 0

Responsiveness

Not established in SCI.

Floor/ceiling effect:

Not established in SCI.

Reviewers

Dr. Bill Miller, Matthew Querée

Date Last Updated

26 July 2019

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