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Timed motor test for wheelchair users: initial development and application in children with spinal cord injury
Ross Chafetz1, Craig McDonald, M J Mulcahey
1Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA. rchafetz@shrinenet.org
Insights
The Timed Motor Test (TMT) shows fair-to-good reliability for assessing functional status in children with spinal cord injury (SCI). Wearing a thoracolumbosacral orthosis (TLSO) increased task completion time for these wheelchair users.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomedical Engineering
Background:
- Children with spinal cord injury (SCI) often experience functional limitations.
- Manual wheelchair use is common in this population, necessitating functional assessments.
- Orthotic devices like thoracolumbosacral orthoses (TLSOs) are used to support trunk stability but may impact function.
Purpose of the Study:
- To develop and assess the reliability of the Timed Motor Test (TMT), a new performance-based measure for children with SCI.
- To evaluate the preliminary impact of TLSOs on functional performance in children with SCI using the TMT.
- To provide pilot data on the TMT's utility in SCI research.
Main Methods:
- A cross-sectional observational study design was employed.
- Eleven subjects with SCI using manual wheelchairs were enrolled.
- The TMT included tasks such as donning clothing, transfers, and wheelchair propulsion; reliability was tested, and the impact of TLSO use was analyzed.
Main Results:
- The TMT demonstrated fair-to-good intertester and intratester reliability (ICC ≥ 0.60), except for donning pants.
- Participants were significantly slower in completing TMT tasks (dressing, transfers, propulsion) when wearing a TLSO (P < 0.05).
- A preference was noted for not wearing a TLSO during dressing and transfer activities.
Conclusions:
- The TMT is a reliable measure for assessing functional status in pediatric SCI wheelchair users.
- TLSO use was associated with increased time to complete functional tasks in children with SCI, as measured by the TMT.
- These findings suggest that TLSOs may present functional challenges for children with SCI, impacting their daily activities.
Objective:
The objective of this study was to describe the development and preliminary results of reliability testing of the timed motor test (TMT), a performance-based measure of functional status for children with a spinal cord injury (SCI) who use a manual wheelchair. This study will also provide pilot data using the TMT to examine the impact of thoracolumbosacral orthoses (TLSO) on function in children with a SCI.
Study Design:
Cross-sectional observational study. METHODS/PARTICIPANTS: This study enrolled 11 subjects with SCI. The TMT consisted of donning a shirt, donning pants, even transfers, uneven transfers, and propelling a wheelchair 80 feet and up a ramp of 45 feet. Nine subjects completed the TMT with and without a TLSO, and 6 subjects (4 of whom also completed the TMT with and without a TLSO) completed the reliability testing.
Results:
Except for donning pants, the intertester and intratester reliability of the TMT was fair-to-good with intraclass correlation coefficients (ICCs) of 0.60 or greater. When wearing a TLSO, participants were slower at donning a shirt, donning pants, performing even and uneven transfers, and hallway propulsion (P < 0.05). There was a preference for not wearing a TLSO for dressing and transfer skills.
Conclusion:
In general, the TMT for wheelchair users had fair-to-good intertester and intratester reliability. Based on these pilot data, there was an increase in time to complete several functional tasks because of the use of a TLSO as measured by the TMT in children with a SCI.
