Validity of the WST and the WST-Q in children with spina bifida: a pilot project

Objective: To begin exploring use of the manual wheelchair versions of the Wheelchair Skills Test (WST) and the Wheelchair Skills Test-Questionnaire (WST-Q) in children with spina bifida who use manual wheelchairs. Design: Cross-sectional, psychometric study. Setting: A university-based laboratory setting. Subjects: A total of 12 children 5-21 years of age with spina bifida participated in the study. Interventions: Assessment of manual wheelchair skills by direct observation and parent report. Main measures: The WST, the WST-Q and the manual wheelchair short scale within the Mobility domain of the Pediatric Evaluation of Disability-Computer Adapted Test (MWC PEDI-CAT), an existing validated parent-report measure of manual wheelchair skills in children. Results: Moderate to excellent positive associations were found amongst all test scores. Spearman's rank order correlations were as follows: r = 0.87 between the WST and WST-Q, r = 0.78 between the WST-Q and MWC PEDI-CAT and r = 0.62 between scores on the WST and MWC PEDI-CAT. These associations suggest that the WST and the WST-Q may be appropriate for use with children who have spina bifida and therefore should be further explored in this population. Using the WST-Q as a parent-report measure may help clinicians to assess manual wheelchair skills in children with spina bifida without adding additional time to an examination session. Implications for Rehabilitation The associations found in this pilot project suggest that the Wheelchair Skills Test and the Wheelchair Skills Test-Questionnaire (WST-Q) may be appropriate for use with children who have spina bifida. Using the WST-Q as a parent-report measure may help clinicians to assess manual wheelchair skills in children with spina bifida without adding additional time to an examination session.