Archives of physical medicine and rehabilitation vol:94 issue:4 pages:761-70
OBJECTIVE: To assess the reliability of the Test of Wheeled Mobility (TOWM) and the Wheelie test DESIGN: Cohort study SETTING: Gymnasium at the Katholieke Universiteit Leuven PARTICIPANTS: Thirty manual wheelchair-users (Age 23-53 years) with a spinal cord injury INTERVENTION: Participants performed the 30 skills of the TOWM and 8 skills of the Wheelie test twice. Ability, time and anxiety scores were assessed on-field. Quality scores were assessed by video analysis. MAIN OUTCOME MEASURE: Test-retest reliability was evaluated for the ability, time, anxiety and quality scores of both tests. Intrarater and interrater reliability were determined based on the quality scores of 20 participants. Intraclass coefficient and non-parametric statistics were applied, as well as standard error of measurement (SEM), method error (ME), coefficient variation of method error (CV(ME)), minimal detectable change (MDC(95)), and technical error of measurement (TEM). RESULTS: Test-retest reliability: no significant differences between t1 and t2 in the ability, quality and time scores, except to the anxiety scores. SEM, ME CV(ME) and MDC(95) values were low for the ability and quality total score and higher for the time and anxiety total score. Intrarater and interrater reliability ICC's of both tests ranged between 0.91-0.99. Interrater relative TEM for the TOWM and the Wheelie test total quality score was 3.7% and 6.3% respectively and intrarater relative TEM was 4.3% and 6.1%. ICC's per individual tasks, ranged between 0.88-1.00, except for 'level propulsion forward' that showed low ICC scores (Interrater: 0.49; intrarater: 0.44; test-retest: 0.43). CONCLUSIONS: Based on ability and quality total scores, the TOWM and the Wheelie test are reliable when assessing wheeled mobility of manual wheelchair users with SCI. The quality criteria of one task from the TOWM and three tasks from the Wheelie test need to be refined.