- Used to objectively evaluate manual wheelchair skills and safety
- Can be used during the initial provision of the wheelchair and as necessary at follow-up
- There are multiple versions of this measure for manual wheelchairs, powered wheelchairs, and scooters, for both wheelchair users and caregivers (excepting scooters).
- As of August 2024, the latest version of all tests and forms is 5.4.
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 typically takes 30 minutes to administer and the WST-Q takes 10 minutes.
ICF Domain
Activity ▶ Mobility
Administration
Approximately 30 min. for WST and 10 min. for WST-Q (Questionnaire version).
Number of Items
Manual Wheelchair test: 33 tasks; Power Wheelchair test: 25 tasks.
Equipment
- Approximately 1000 square feet of space.
- A standardized wheelchair circuit or access to a variety of natural barriers (e.g. ramps, curbs, potholes, etc.) and the person’s usual wheelchair.
Scoring
- Each skill is scored from 0-3 (Fail = 0; Pass with Difficulty or Assistance = 1; Pass = 2; Advanced Pass = 3).
- Some skills may be marked NP (Not Possible); they can be subtracted from the denominator to avoid affecting the Total Score.
- The tester should also record any comments that are instructive (e.g. reasons for failures, left-right asymmetry).
- To get a percentage WST Capacity Score add up all scores, divide by number of possible skills (minus number of NP scores and number of TE scores) and multiply by 3 (and 100%).
Languages
Available in English, French, Brazilian Portuguese (WST-Q 4.3), and Spanish (WST 4.2)
Training Required
No formal training required. However, test familiarization and a spotter are mandatory, as well as reading the manuals (WST Manual, WST Program Manual) is recommended.
Availability
The materials are continuously being updated for free so visit www.wheelchairskillsprogram.ca for the latest. All manuals and forms are available here.
Measurement Property Summary
Number of studies reporting psychometric properties: 11
Interpretability
- Higher scores indicate greater wheelchair skills
- MCID: not established in SCI
- SEM: 5.0 (Rushton et al. 2016: N = 72, 19% SCI; 36 males; mean(SD) age 60.7 (7.3))
- MDC: 6.2 (Rushton et al. 2016: N = 72, 19% SCI; 36 males; mean(SD) age 60.7 (7.3))
Threshold Values
55.6% of participants (28.6% of tetraplegic participants) scored over 80% (empirical cut-off for distinguishing people with advanced MWC skills, mainly skills required to control wheelies)
(Lemay et al., 2011; N = 54, 41 male; mixed injury types; 12+ months of manual WC use)
Reliability – Moderate to High
Number of studies reporting reliability data: 7
- Moderate to High test-retest reliability: ICC = 0.84-0.94
(For measured speeds; Pradon et al., 2012: N = 40, 30 male; mixed injury types; mean (range) 79.8 (1-360) months in rehabilitation)
- Moderate to High test-retest reliability: ICC = 0.91
(WST v.4.1 for manual wheelchair users; Lindquist et al., 2010: N=11, 9 SCI, 9 male; no info on SCI types)
- Moderate to High inter-rater reliability: (ICC = 0.92-0.95, Cronbach’s Alpha = 0.95)
(For measured speeds; Pradon et al., 2012: N = 40, 30 male; mixed injury types; mean (range) 79.8 (1-360) months in rehabilitation; Kirby et al., 2002; N = 24, 3 SCI; 16 male; mixed diagnoses)
- Moderate to High inter-rater reliability: ICC = 0.855
(WST v.4.1 for manual wheelchair users; Lindquist et al., 2010: N = 11, 9 SCI, 9 male; no info on SCI types)
- High intra-rater reliability: (ICC = 0.950, Cronbach’s Alpha = 0.96)
(WST v.4.1 for manual wheelchair users; Lindquist et al., 2010: N = 11, 9 SCI, 9 male; no info on SCI types; Kirby et al., 2002; N = 24, 3 SCI; 16 male; mixed diagnoses)
- High internal consistency: Cronbach’s Alpha = 0.90
(Rushton et al. 2016; N = 72, 19% SCI; 36 males; mean(SD) age 60.7 (7.3))
Validity – Moderate to High
Number of studies reporting validity data: 9
- Moderate correlation with Wheeled Distance per Day: r = 0.36
- Moderate correlation with age: r = -0.32
(Lemay et al. 2011; n=54; 41 males; tetraplegia and paraplegia; 12+ months of manual WC use)
- Moderate correlation with Measured Speeds: r = 0.57-0.75
(Absolute values of correlations; Pradon et al. 2012; n=40; 30 males; tetraplegia and paraplegia; mean (range) 79.8 (1-360) months in rehabilitation)
- High correlation between the WST and WST-Q: r = 0.65
(Rushton et al. 2016; n= 72; 19% SCI; 36 males; mean (SD) age: 60.7 (7.3) years)
Predictive Validity
WST predicts CHART and SWLS scores.
(Hosseini et al., 2012; N=214; mixed injury types; mean(SD) 11.7(11) years post SCI)
Responsiveness
Not established in SCI
Floor/Ceiling Effect
No values were reported for the presence of floor/ceiling effects in the WST for the SCI population.
Reviewers
Dr. Carlos L. Cano-Herrera, Elsa Sun
Date Last Updated
December 31, 2024
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
