Abstract
Objective
To evaluate the measurement properties of clinical instruments used to assess manual
wheelchair mobility in individuals with spinal cord injury (SCI).
Data Sources
This systematic review was conducted according to the Consensus-Based Standards for
the Selection of Health Measurement Instruments guidance and Preferred Reporting Items
for Systematic Reviews and Meta-Analyses statement. The search was conducted up to
December 2021 on MEDLINE/PubMed, Cochrane Central Register of Controlled Trials, Web
of Science, Biblioteca Regional de Medicina, and Cumulative Index to Nursing and Allied Health databases without time restriction.
Study Selection
Peer-reviewed original research articles that examined any clinical wheelchair mobility
and/or skill assessment instrument among adults with SCI and reported data on at least
one measurement property or described the development procedure were evaluated independently
by two reviewers.
Data Extraction
Data were independently extracted according to Consensus-Based Standards for the Selection
of Health Measurement Instruments methodology. Measurement property results from each
study were independently rated by two reviewers as sufficient, insufficient, indeterminate,
or inconsistent. The evidence for each measurement property was rated as high, moderate,
low, or very low (Grading of Recommendations, Assessment, Development, and Evaluation).
Recommendations for highly-rated instruments were performed.
Data Synthesis
Twenty-nine studies with 21 instruments were identified. The methodological quality
of studies ranged from insufficient to sufficient, and the quality of evidence ranged
from very low to high. Six instruments reported content validity. Reliability and
construct validity were the most studied measurement properties. Structural validity
and invariance for cross-cultural measurement were not reported. The highly rated
instruments were the Wheelchair Outcome Measure and Wheelchair Skills Test Questionnaire.
Conclusions
Although numerous instruments for assessing wheelchair mobility and/or skills among
individuals with SCI were identified, not many measurement properties have been sufficiently
established. The Wheelchair Outcome Measure and Wheelchair Skills Test Questionnaire
show the current best potential to be recommended for clinical and research use. Further
studies are needed to strengthen or change these recommendations.
Keywords
List of abbreviations:
AIS (American Spinal Injury Association Impairment Scale), COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments), 5AML-FIM (5 Additional Mobility and Locomotor in FIM), GRADE (Grading of Recommendations, Assessment, Development, and Evaluation), PROM (patient-reported outcome measure), QEWS (Queensland Evaluation of Wheelchair Skills), SCI (spinal cord injury), SEWM (Self-efficacy in Wheeled Mobility Scale), TOWM (Test of Wheeled Mobility), WC-PFP (Wheelchair Physical Functional Performance), WhOM (Wheelchair Outcome Measure), WPT (Wheelchair Propulsion Test), WST (Wheelchair Skills Test), WST-Q (Wheelchair Skills Test Questionnaire), WUFA (Wheelchair Users Functional Assessment)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 19, 2022
Accepted:
October 3,
2022
Received in revised form:
September 26,
2022
Received:
May 18,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil, Finance Code 001 and Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina (FAPESC), Brazil, TO 2019TR767.
Systematic Review Registration No. (PROSPERO): CRD42019138301.
Disclosures: none.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
