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Wheelchair Skills Test 4.1 (WST) – Spinal Cord Injury (SCI)
Summary
What it measures:
Manual wheelchair skills 2 total scores for version 4.1: safety and performance; safety component added to help clinicians identify completion of a skill based on patient judgment Psychometrics of WST 4.2 are being reviewed
Target Population:
- People using manual wheelchairs for community locomotion (spinal cord injury, stroke, elderly)
- People with spinal cord injury
Professional Association Recommendations
Recommendations from the APTA Neurology Section’s SCI EDGE Taskforce are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
SCI EDGE:
- Reasonable to use, but limited study in target group in acute and subacute levels of acuity
- Recommended for chronic level of acuity
- Reasonable to use, but limited study for AIS classifications A/B and C/D
- Not recommended that students learn to administer the tool or receive exposure to the tool
- Recommended for use in intervention research studies
Normative/Reference Data
Community manual wheelchair users (Lindquist et al, 2010):
Mean WST 4.1 score for performance=80.1% (±8.5%); range= 63.3%-100.0%
Mean WST 4.1 score for safety=98.0% (±2.8%); range=89.7%-100.0%
Chronic SCI (Lemay, 2012) - mean scores by level of injury:
All levels (C4-L2) combined=80.7±11.8
Tetraplegia (C4-C8)=72.1±7.9
High paraplegia (T1-6)=82.8±9.1
Low paraplegia (T7-L2)=84.0±12.4
Ceiling and Floor Effects
Manual Wheelchair Users (Lindquist, 2010):
Possible ceiling effect for safety score with mean score of 98%±2.8% (range=89.7%-100%)
Chronic SCI (Lemay, 2012):
Ceiling effect:
83% of study participants had score of 100% on safety subscale (range=87.5%-100%)
No issues noted for performance subscale (mean performance score = 80.7%±11.8%)
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Date: February 2, 2014
Contact: practice@apta.org
Content Type: Test & Measure
Kelsey DeLave (extractor); Phyllis Palma, PT, DPT, Rachel Tappan, PT, Board-Certified Neurologic Clinical Specialist, and the SCI EDGE task force of the Neurology Section of the APTA (original RMD reviewers)
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