The Timed Manual Wheelchair Slalom Test: A Reliable and Accurate Performance-Based Outcome Measure for Individuals With Spinal Cord Injury

Gagnon D, Decary S, Charbonneau M-F. The timed manual wheelchair slalom test: a reliable and accurate performance-based outcome measure for individuals with spinal cord injury. Arch Phys Med Rehabil 2011;92:1339-43. Objectives: To describe the timed manual wheelchair slalom test (MWST) and to quantify its test-retest reliability, standard error of measurement, and minimum detectable change (MDC). Design: Repeated-measures design. Setting: Pathokinesiology laboratory. Participants: Manual wheelchair users (N=15) with spinal cord injury (SCI) (vertebral levels, C6 to T12; American Spinal Injury Association Impairment Scale: A, B, or C) participated in this study. Participants were 40.7 +/- 12.6 years of age, measured 1.77 +/-.08m in height, weighed 79.6 +/- 23.9kg, and had been using a manual wheelchair as their primary mode of mobility for 5.9 +/- 7.5 years. Interventions: Participants propelled their own wheelchair at a self-selected maximum velocity along a slalom trajectory (linear length, 18m) defined by 7 cones aligned in a straight line and set 3m, 2m, and 1m apart from one another. Three trials (T=3) of the MWST were performed on 2 separate visits (V=2) 6.3 +/- 5.4 days apart. The generalizability theory was used to determine the reliability, standard error of measurement, and MDC and to propose testing protocols for the MWST. Main Outcome Measure: The time needed to complete the MWST expressed in seconds. Results: All participants successfully completed the MWST. No adverse effect was reported. The time required to complete the MWST at visits 1 and 2 was 16.8 +/- 4.4 and 16.5 +/- 4.3 seconds, respectively. The reliability coefficient (phi=.981) and accuracy (standard error of measurement=3.47%, MDC=8.097%) were high when the time required for a participant to perform 3 MWST trials during a single visit (T=3, V=1) was averaged. Conclusions: The timed MWST is a safe, reliable, and accurate performance-based outcome measure that can be administered easily and quickly in individuals with SCI who rely on a manually propelled wheelchair for mobility.