Development, reliability and validity of the queensland evaluation of wheelchair skills (QEWS)

- Objectives\ud \ud To develop and test a valid and reliable assessment of wheelchair skills for individuals with spinal cord injuries (SCI); the Queensland Evaluation of Wheelchair Skills (QEWS).\ud \ud \ud - Setting\ud \ud Hospital, Australia.\ud \ud \ud - Methods\ud \ud Phase 1: Four Delphi panel rounds with clinical experts were used to develop the QEWS. \ud \ud Phase 2: Intra-rater and inter-rater reliability of the QEWS items were examined in 100 people with SCI. \ud \ud Phase 3a: Concurrent validity was investigated by examining the association between QEWS total scores and physiotherapists’ global ratings of wheelchair skill performance. \ud \ud Phase 3b: Construct validity was tested in 20 people with recent SCI by examining change in QEWS total scores between when they first mobilised in a wheelchair and scores obtained 10 weeks later.\ud \ud \ud - Results\ud \ud Phase 1: The QEWS was developed. \ud \ud Phase 2: The intra-class correlation coefficients reflecting the intra-rater reliability and the inter-rater reliability for the QEWS total score were 1.00 and 0.98, with scores being within one point of each other 96 and 91% of the time, respectively. \ud \ud Phase 3a: The QEWS total scores were comparable with the global rating of wheelchair skill performance (r2=0.93). \ud \ud Phase 3b: The QEWS scores changed by a median (interquartile range (IQR)) of 4 (1 to 6) points over the 10-week period following first wheelchair mobilisation.\ud \ud \ud - Conclusion\ud \ud The QEWS is a valid and reliable tool for measuring wheelchair skills in individuals with SCI. The QEWS is efficient and practical to administer and does not require specialised equipment

Optimization And Ergonomics Of Novel Modular Wheelchair Design

The Manual Wheelchair (MW) is an important device which provides technical assistance to people affected by mobility impairments. This mode of displacement is neither natural nor easy and the environments, whether natural or built, can present various obstacles, which will restrict mobility and the social participation of MW users. Users complete autonomy depends on their capacity to cope with the many obstacles of their daily life, such as pavements or unleveled grounds. Ever since its invention the MW as an economical mobility solution, it has gone through many improvements, yet its technological innovation slowed down during the recent years. In this study, we present a novel design of MW. Its conception includes innovative kinematics with genuine lifting and folding systems. A lever system mounted on hubless-wheels is dedicated to the propulsion mechanism. The objective of this new concept is the optimization of MW mechanism to be more user friendly and to take into account the ergonomics considerations in an attempt to improve the user’s daily life

Rasch analysis of the University of Washington Self-Efficacy Scale short-form (UW-SES-6) in people with long-standing spinal cord injury

Study design Cross-sectional psychometric study. Objectives The University of Washington Self-Efficacy Scale (UW-SES) is a measure of self-efficacy regarding managing challenges related to multiple sclerosis or spinal cord injury (SCI) that can be used across disabling conditions. The objective of this study was to examine the psychometric properties of its short form, the UW-SES-6, using the Rasch model. Setting Community, The Netherlands. Methods Secondary analysis of data from the ALLRISC study. Participants were 261 individuals with a time since onset of SCI (TSI) for at least 10 years, 18-35 at the onset of SCI, and used a wheelchair in everyday life. Rasch analyses were conducted to examine stochastic ordering (fit), unidimensionality, local dependency, reliability, response scale structure, targeting, and item bias. Results Median age was 47.8 years (Inter-Quartile Range (IQR) 41.9-55), median TSI was 22 years (IQR 16.8-30.3), 73.6% were male, 90.4% had a traumatic SCI, 39.8% had tetraplegia, and 81.6% had motor complete SCI. After merging the middle three response categories of item 4, the UW-SES-6 showed satisfactory item fit without local dependence. The PSI was high (0.87). Comparison of the person and item threshold distributions showed satisfactory targeting of the UW-SES-6 to the study group. No differential item functioning was seen with respect to sex, age, level of education, level and completeness of lesion, and TSI. Conclusions This study showed the UW-SES-6 to be a scale with sound psychometric properties that can be used as a quick and easy self-report measure of self-efficacy in people with SCI

Associations between disability-management self-efficacy, participation and life satisfaction in people with long-standing spinal cord injury

Objectives: To study disability-management self-efficacy (DMSE) and its correlates in a large sample of Dutch people with long-standing spinal cord injury (SCI). DMSE is the confidence that people with SCI may have in their ability to manage the consequences of their condition with respect to the various domains in their life. Research questions were: (1) What is the level of DMSE in Dutch people with long-standing SCI?; (2) Is DMSE associated with demographic and lesion characteristics?; and (3) Is DMSE associated with participation and life satisfaction if these associations are adjusted for demographic and lesion characteristics and mood? Methods: Eligible people were identified from all eight rehabilitation centers with a specialty in SCI rehabilitation in the Netherlands (N=261). Data were collected using a self-report questionnaire. DMSE was measured using the University of Washington Self-Efficacy Scale-Short Form (UW-SES-6). Correlation and linear regression analyses were used. Results: Levels of UW-SES-6 scores were largely independent of demographic and lesion characteristics. UW-SES-6 scores were bivariately moderately to strongly associated with mood (0.47), participation (0.39-0.51) and life satisfaction (0.46). In the regression analyses, UW-SES-6 scores still explained a significant amount of variance of participation (standardized beta 0.31-0.33) and life satisfaction (standardized beta 0.21) when controlling for demographic and lesion characteristics and mood, and explained an additional 3.2-8.1% of the variance of participation and life satisfaction. Conclusion: DMSE is a psychological resource associated with higher levels of participation and life satisfaction after SCI. The UW-SES-6 is a brief and easy to use measure of this psychological resource