Wheelchair Skills test - questionnaire for manual wheelchair users: Italian translation and preliminary validation

To translate and culturally adapt the Wheelchair Skills Test-Questionnaire (WST-Q) into Italian, and to assess its reliability, measurement error and validity in manual wheelchair users.

The WST-Q was translated and culturally adapted using forward-backward translation, expert review, and cognitive debriefing with wheelchair users and rehabilitation professionals. Internal consistency (Cronbach's α), test-retest reliability (Intraclass Correlation Coefficient, [ICC]), measurement error (Standard Error of Measurement [SEM] and the Smallest Real Difference [SRD]) were calculated. Validity was examined through WST-Q scores correlations (concurrent validity) and known-groups comparisons (years of use, training) (construct validity). A General Linear Model (GLM) was used to explore the effects of clinical and demographic factors, accounting for interaction terms.

Seventy-four manual wheelchair users, with a mean age of 44.0 years (SD: 15.7), participated in the study. Cronbach's α was 0.96-0.97 across WST-Q scores. ICCs indicated excellent test-retest reliability (0.88-0.92). SEM ranged from 4.9 to 6.9, and SRD from 13.6 to 19.3. Strong correlation among WST-Q scores was observed (p = 0.81-0.90, p < 0.001). Known-groups validity showed higher scores in participants with >2 years of wheelchair use and in those with training. GLM analysis identified significant effects of baseline pathology, wheelchair type, gender, and training, with several interaction effects, explaining 77-89% of score variance.

The Italian WST-Q demonstrated excellent reliability, acceptable measurement error, and good validity. It is suitable for assessing self-reported manual wheelchair skills in Italian rehabilitation settings, supporting standardised and evidence-based practice.