Demographics of the Dutch multicenter prospective cohort study 'Restoration of mobility in spinal cord injury rehabilitation'

Study design: A multicenter prospective cohort study. Objective: To compare the demographic data of the included population with other studied spinal cord injury (SCI) populations in the international literature. Setting: Eight Dutch rehabilitation centers with a specialized SCI unit. Methods: A total of 205 individuals with SCI participated in this study. Information about personal, lesion and rehabilitation characteristics were collected at the beginning of active rehabilitation by means of a questionnaire. Results: The research group mainly consisted of men (74%), of individuals with a paraplegia (59%), and had a complete lesion (68%). The SCI was mainly caused by a trauma (75%), principally due to a traffic accident (42%). The length of clinical rehabilitation varied between 2 months and more than a year, which seemed to be dependent on the lesion characteristics and related comorbidity. Conclusions: The personal and lesion characteristics of the subjects of the multi-center study were comparable to data of other studies, although fewer older subjects and subjects with an incomplete lesion were included due to the inclusion criteria'age' and 'wheelchair-dependent'. The length of stay in rehabilitation centers in The Netherlands was longer compared to Denmark but much longer than in eg Australia and the USA. © 2006 International Spinal Cord Society. All rights reserved

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

Objective assessment of mobility of the spinal cord injured in a free-living environment

An exploratory study of the practicality and feasibility of an instrument. To adapt an activity monitor for use on a wheelchair to assess long-term mobility in a free-living environment in the spinal cord injury (SCI) population, and to explore the utility of the data collected. An activity monitor was adapted for use on a wheelchair wheel. The monitor was used to assess, for 1 week, the wheelchair mobility of seven participants with SCI who only used a wheelchair. In conjunction with a second monitor on the thigh the mobility of seven participants with SCI who used a wheelchair and upright mobility, and five healthy non-wheelchair users, were assessed for 1 day. The adapted monitor collected 1260 h of data and was suitable for use on both manual and electric wheelchairs. During 1 week, participants with SCI who only used a wheelchair spent between 4 and 13 h moving in the wheelchair, covering a distance of between 7 and 28 km. Distinct differences in mobility were shown between participants with an SCI and non-wheelchair users. The differences in time spent in mobility activities between the groups of participants with SCI were smaller. The system was successfully used in this group of participants with SCI, and could provide useful information on the mobility of people with SCI in a free-living environment