Conceptual issues in the measurement of participation among wheeled mobility device users

To review current measurement approaches to activity and participation among wheeled mobility users and suggest key factors researchers should consider as they continue to develop and refine both the concept of participation and its measurement.

Literature review and expert opinion.

Four issues are reviewed: (1) Participation as a concept and as a key domain of the revised International Classification of Functioning, Disability and Health (ICF). (2) The 'perspective' of current participation self-reports as they reflect the underlying cultural values of autonomy and independence. (3) The lack of sensitivity in current participation measures to assistive technology. (4) The significance of the ICF qualifiers 'capacity' and 'performance' to the accurate assessment of activity and participation among wheeled mobility users.

The following suggestions are offered as researchers continue to develop increasingly sophisticated instruments and methods: (1) participation measures need to be device-specific; (2) measures ought to capture both 'capacity' and 'performance'; (3) methods need to be sensitive to those factors that impact mobility device use over time; (4) methods need to be sensitive to the complexities of both the social and physical environment as they impact device use; and (5) measures need to reflect the impact of multiple mobility device use.