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Chronic SCI, WST version 4.1:

(Lemay 2012; n = 54; mean age = 46.7 (12.8) years; time since initiating wheelchair use = 16.0 (11.2) years, range = 1-40 years; Level of injury: 25.9% C4-C8, 18.5% T1-6, 55.6% T7-L2; severity of injury: 50% complete SCI, 50% incomplete SCI)

• People with score ¡Ý 80% have advanced manual wheelchair skills based on observation

Chronic SCI, WST version 4.1:

(Lemay 2012)

• Mean scores by level of injury:
  • All levels (C4-L2) combined = 80.7 ¡À 11.8 
  • Tetraplegia (C4-C8) = 72.1 ¡À 7.9 
  • High paraplegia (T1-6) = 82.8 ¡À 9.1 
  • Low paraplegia (T7-L2) = 84.0 ¡À 12.4

Predictive Validity

Chronic SCI:

(Hosseini 2012; n = 214; Mean age = 38.8 (12) years; Mean time since injury = 11.7 (11) years (range = 0.9-50 years); Level of injury = C3-L5, 72% with paraplegia, 28% with tetraplegia) 

• WST version 4.1 score predicted CHART score, Satisfaction with Life Scale score, and self-perceived health status on multiple linear regression (p < 0.05)

Chronic SCI, WST version 4.1:

(Lemay 2012)

• Adequate correlation between WST version 4.1 score and wheeled distance per day (r = 0.36) and age (r = -0.32)
• People with tetraplegia (C4-8) scored lower than people with low level paraplegia (T7-L2) (mean score = 72.1% ¡À 7.9% and 84.0% ¡À 12.4% respectively) 

SCI, WST version 3.2:

(Pradon 2012; n = 40; mean age = 36.9 (11.2) years; mean time of wheelchair use = 79.8 months (range 1-360); 18 with low paraplegia (T10-L3), 15 with high paraplegia (T1-9), 7 with tetraplegia (C6-7))

• Excellent correlation between WST version 3.2 and maximum velocity of wheelchair propulsion (r = 0.72) 
• Adequate correlation between WST version 3.2 and spontaneous velocity of wheelchair propulsion (r = 0.57)

• The evolution of the WST has been based on clinical and research experience, feedback from users, and assessments of its measurement properties. (Lindquist et al, 2010)
• In the pilot testing of WST version 1.0, 30 of 33 wheelchair skills were unanimously supported by occupational therapists performing testing (n = 9) (Kirby, 2002)
• Mean visual analog scale rating of usefulness of WST version 1.0 = 59% ¡À 22% (Kirby, 2002)

Chronic SCI:

(Lemay 2012)

• Ceiling effect: 83% of study participants had a score of 100% on safety subscale (range = 87.5%-100%). No issue noted for performance subscale (mean performance score = 80.7% ¡À 11.8%)

Community manual wheelchair users:

(Lindquist et al, 2010, version 4.1, n = 11; Age (years): 42.16 ¡À 16.2; Sex (male/female) 9/2; 30 of the 32 items tested)

• Mean WST 4.1 score for performance 80.1% (¡À 8.5%) range 63.3%-100.0%
• Mean WST 4.1 score for safety 98.0% (¡À 2.8%) range 89.7%-100.0%

Community manual wheelchair users:

(Lindquist et al, 2010, version 4.1, n = 11)

• Performance score (substantial agreement)
  • Test-retest reliability, ICC= 0.901
• Safety score Excellent (none to slight agreement) 
  • Test-retest reliability, ICC= 0.254

Wheelchair Users and Non-Wheelchair Users, WST version 2.4:

(Kirby 2004; n = 298, 129 able-bodied, 62 with amputation, 20 with musculoskeletal disorders, 34 with SCI, 52 with CVA; mean age = 43.8 (22.5) years)

• Excellent test-retest reliability (ICC = 0.904)

Community manual wheelchair users:

(Lindquist et al, 2010, version 4.1, n = 11)

• Performance score (substantial agreement)
  • Excellent interrater reliability, ICC = 0.855
  • Excellent intrarrater reliability, ICC = 0.950
• Safety score Excellent (none to slight agreement)
  • Poor interrater reliability, ICC = 0.061
  • Poor iIntrarater reliability, ICC = 0.228
• Most (54%) performance and safety discrepancies occurred because of scoring rule interpretations. 

Wheelchair Users and Non-Wheelchair Users, WST version 2.4:

(Kirby 2004)

• Excellent interrater reliability (ICC = 0.959)
• Excellent intrarater reliability (ICC = 0.968)

Concurrent Validity

Manual Wheelchair Users, WST version 1.0:

(Kirby 2002; n = 24, 11 with amputation, 4 with stroke, 3 with musculoskeletal disorders, 3 with SCI, 3 with neuromuscular disorders); Mean age = 59 (19) years; mean time using any wheelchair = 51 (144) weeks)

• Adequate correlation between WST scores and occupational therapists¡¯ global ratings of wheelchair skills (r = 0.40-0.54)
• Adequate correlation between changes in WST scores and changes in occupational therapists¡¯ global ratings of wheelchair skills before and after rehabilitation (r = 0.45)

Convergent Validity

Wheelchair Users and Non-Wheelchair Users, WST version 2.4:

(Kirby 2004)

• Adequate correlation between WST version 2.4 and age (r = -0.434)

• Version 4.1 includes more advanced skills (i.e. getting up off the floor and ascending and descending stairs). This was done to reduce the likelihood of a ceiling effect. 

Manual Wheelchair Users, WST version 4.1:

(Lindquist 2010)

• Possible ceiling effect for safety score with mean score of 98% ¡À 2.8% (range 89.7%-100%)

Manual Wheelchair Users, WST version 3.1:

(Best 2005; mean age = 49 (16) years for experimental group, 48 (23) years for control group; Mean wheelchair experience = 11 (151) months for experimental group, 34 (66) months for control group) 

• People who participated in a ¡°Wheelchair Skills Training Program¡± (WTSP) had a relative improvement of 24.0% on WST version 3.1 score, which was statistically significantly greater than the relative improvement of 4.8% in the control group.