• The Wheelchair Circuit is a performance-based measure that 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).

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 WC consists of 9 observational tasks on mobility; this may cause significant patient and clinician burden.

ICF Domain

Activity ▶ Mobility

Administration

Approximately 30-45 min, 8-9 tasks (with 2 min of rest between each task)

Number of Items

9

Equipment

  • Adjustable mat
  • Wheelchair Treadmill (with 3% and 6% grade)
  • Heart Rate monitor, Stopwatch
  • 0.10 m platform on floor
  • Wood doorstep height 0.4 m
  • Open space
  • 15 m corridor

Scoring

  • Successful performance of the task (Y/N), time (seconds), and/or physical strain (peak HR) are recorded. Ability score (0-8 or 0-9): number of tasks completed adequately. For 3 tasks, 0.5 may be awarded if it is partially completed. Separate scores for ability (ordinal scale); performance time (seconds); and physical strain (formula using HR data) are calculated.
  • For the 8-item version:
    • Performance time score: sum of the times taken during “figure-of-8-shape” and “15m-sprint”
    • Physical strain score: mean peak HR between 3% & 6% slope tasks, expressed in bpm or %HRR

Languages

English

Training Required

None, however experience in exercise testing is helpful.

Availability

The Wheelchair Circuit worksheet can be found here.

Measurement Property Summary

Number of studies reporting psychometric properties: 2

Interpretability

MCID: not established in SCI population

SEM:

Performance Time: Task SEM
Figure-of-8 shape 1.5
Crossing doorstep 2.2
Mounting platform 2.3
Sprint 0.6
Transfer 12.2
Peak Heart Rate: Task
Figure-of-8 shape 6.8
Crossing doorstep 6.4
Mounting platform 7.7
Sprint 7.5
Walking 4.4
3% slope 9.1
6% slope 6.7
Wheelchair driving 6.9
Transfer 9.2

(Calculated from Kilkens et al., 2002: N=27; mixed injury types; final stage of clinical rehabilitation)

MDC:

Test table Test
Figure-of-8 shape 4.1
Crossing doorstep 6.1
Mounting platform 6.2
Sprint 1.5
Transfer 33.8
Peak Heart Rate: Task
Figure-of-8 shape 18.9
Crossing doorstep 17.7
Mounting platform 21.3
Sprint 20.9
Walking 12.2
3% slope 25.3
6% slope 18.5
Wheelchair driving 19.2
Transfer 25.7

(Calculated from Kilkens et al., 2002: N=27; mixed injury types; final stage of clinical rehabilitation)

  • 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).

Reliability – Moderate to High

  • High inter-rater reliability:
    • Overall task feasibility/ability: ICC = 0.97
    • Task feasibility/ability for individual items: ICC = 0.76-0.98
    • Peak HRs: ICC = 0.82-0.99
  • Moderate to High intra-rater reliability:
    • Overall task feasibility/ability: ICC = 0.98
    • Performance times: ICC = 0.71-0.99
    • Peak HRs: ICC = 0.68-0.96

(Kilkens et al., 2002: N=27; mixed injury types; final stage of clinical rehabilitation)

Validity – Moderate

Moderate correlation with Functional Independence Measure (FIM) – Mobility subscale:

  • Ability Score: r = 0.517 (Admission), 0.519 (Discharge)
  • Performance Time Score: r = -0.466 (Admission), -0.396 (Discharge)

(Kilkens et al. 2004, 8-task version; n=74, 51 males; mean (SD) age: 40.5 (14.5) years; majority of participants had paraplegia)

Responsiveness

Standardized response mean between start of rehabilitation program and discharge is:

  • 0.6 for Ability score
  • 0.9 for Performance time score
  • 0.8 for Physical strain score.

(Kilkens et al. 2004, 8-task version; n=74, 51 males; mean (SD) age: 40.5 (14.5) years; majority of participants had paraplegia)

Floor/Ceiling Effect

Not established in SCI population

Reviewers

Dr. Carlos L. Cano-Herrera, Tyra Chu

Date Last Updated

December 31, 2024

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

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