Discriminatory validity of the Aspects of Wheelchair Mobility Test as demonstrated by a comparison of four wheelchair types designed for use in low-resource areas

Abstract

BackgroundComparative effectiveness research on wheelchairs available in low-resource areas is needed to enable effective use of limited funds. Mobility on commonly encountered rolling environments is a key aspect of function. High variation in capacity among wheelchair users can mask changes in mobility because of wheelchair design. A repeated measures protocol in which the participants use one type of wheelchair and then another minimises the impact of individual variation.ObjectivesThe Aspects of Wheelchair Mobility Test (AWMT) was designed to be used in repeated measures studies in low-resource areas. It measures the impact of different wheelchair types on physical performance in commonly encountered rolling environments and provides an opportunity for qualitative and quantitative participant response. This study sought to confirm the ability of the AWMT to discern differences in mobility because of wheelchair design.MethodParticipants were wheelchair users at a boarding school for students with disabilities in a low-resource area. Each participant completed timed tests on measured tracks on rough and smooth surfaces, in tight spaces and over curbs. Four types of wheelchairs designed for use in low-resource areas were included.ResultsThe protocol demonstrated the ability to discriminate changes in mobility of individuals because of wheelchair type.ConclusionComparative effectiveness studies with this protocol can enable beneficial change. This is illustrated by design alterations by wheelchair manufacturers in response to results.

Development of the Wheelchair Interface Questionnaire and initial face and content validity

“…Study participants confirmed the importance of qualitative and quantitative data, as well as that of data that would provide information specific enough to enable responsive modification and design changes. In other questionnaires using a similar format, the visual analogue scale provides continuous quantitative data while the comments provide qualitative data that gives a reason behind the rating (Rispin et al 2013; Rispin et al 2017b). High discriminatory validity for the WIQ cannot be confirmed until a large study with multiple sets of 10 or more individuals in different types of wheelchairs is completed.…”

“…As might be expected, these are very sensitive to differences in wheelchair users’ capacity, resulting in any information on the interface being overwhelmed by wide differences in users’ capacity (Kirby et al 2004; Mills 2003; Mortenson, Miller & Miller-Pogar 2007; Rushton et al 2011; Stanley et al 2003). Other tools assess multiple factors together, such as maintenance condition and appropriateness, or combine multiple components into one score (Karmarkar, Collins & Cooper 2009) and consequently have low resolution for data that could result in responsive changes in the design of a specific wheelchair component (Rispin et al 2017b). To be useful for wheelchair modification and design changes, a tool must also have high discriminatory validity (Jerosch-Herold 2005; May 1997).…”

The Wheelchair Propulsion Wheel Rotation Angle Function Symmetry in the Propelling Phase: Motion Capture Research and a Mathematical Model

“…The way in which the function of motion is performed depends on the type of wheelchair being used [1][2][3]. The basic classification of wheelchairs defines them as electric, manual, or hybrid wheelchairs [4,5].…”

Test–retest reliability and construct validity of the Aspects of Wheelchair Mobility Test as a measure of the mobility of wheelchair users

“…As described in the accompanying article (Rispin, Hamm & Wee, 2017 ), the AWMT uses measured tracks on four rolling environments: rough, smooth, tight spaces and curbs. These are commonly encountered in low-resource settings and were thought likely to discriminate differences because of wheelchair design.…”