Cultural Adaptation, Validity and Reliability of The Turkish Version of The Wheelchair Skills Test Questionnaire (WST-Q) 5.0 Form in Individuals with Spinal Cord Injury

Abstract

Paraplegic individuals with spinal cord injury (SCI) use a wheelchair to move around. The level of independence they have in the community is related to their wheelchair skills. Therefore, wheelchair skills are important for individuals with SCI. To increase the use of manual wheelchairs, it is important to evaluate the skills of wheelchair users. When the literature was examined, we could not find a scale for evaluating wheelchair skills on the Turkish Scale. Thus, this study aimed to determine the validity and reliability of the Turkish cultural adaptation of the Wheelchair Skills Test Questionnaire (WST-Q) as a questionnaire evaluating the skills of manual wheelchair users in Türkiye. This study was conducted with paraplegic manual wheelchair users. For the reliability of the questionnaire, internal consistency and test-retest reliability were examined. Internal consistency was evaluated with the Cronbach α coefficient. For the validity of the questionnaire, the data obtained from the WST-Q-Turkish were compared with the World Health Organization Quality of Life, Brief Version (WHOQOL-BREF). The study was completed with 20 cases with a mean age of 40±8.95 years. The general Cronbach α score of the questionnaire was calculated as 0.985. According to the results, the questionnaire was determined to be reliable. The currently widely used WHOQOL-BREF was used for the concurrent validity of the WST-Q-Turkish. A strong correlation was determined between the WHOQOL-BREF and the WST-Q-Turkish. In this study, the validity and reliability Turkish of the WST-Q form was performed/evaluated and the final form was named WST-Q-Turkish. The WST-Q-Turkish was determined to be a valid and reliable questionnaire for the evaluation of the skill capacity of paraplegic adults with SCI using a manual wheelchair.

Keywords

• Spinal Cord Injuries
• Paraplegia
• Wheelchairs
• Questionnaire

References

1. 1. Engin O, El Ö. Assessment of the patients with spinal cord injury. TOTBID Dergisi. 2018;17:545–553.
2. 2. Ehrman JK, Gordon PM, Visich PS, Keteyian SJ. Klinik egzersiz fizyolojisi. 3. Baskı. Çev: Arikan H, Ergun N, Özdincler AR, Tugay BU. İstanbul: İstanbul Tıp Kitabevi; 2018.
3. 3. Harvey L. Management of spinal cord injuries: a guide for physiotherapists. China: Churchill Livingstone Elsevier; 2008.
4. 4. Harvey LA, Lin CW, Glinsky JV, De Wolf A. The effectiveness of physical interventions for people with spinal cord injuries: a systematic review. Spinal Cord. 2009 Mar;47(3):184-95.
5. 5. Mountain AD, Kirby RL, Smith C. The wheelchair skills test, version 2.4: Validity of an algorithm-based questionnaire version. Arch Phys Med Rehabil. 2004 Mar;85(3):416-23.
6. 6. Routhier F, Kirby RL, Demers L, Vincent C, Westwood D, editors. Translation of the Wheelchair Skills Program into French: an iterative methodology. 28th International Conference on Technology & Disability: Research, Design and Practice; 2005; Atlanta/USA.
7. 7. Moen U. Oversettelse av Wheelchair Skills Test-Questionnaire versjon 4.3 og undersøkelse av test-retest reliabilitet av den norske versjonen Test for rullestolferdigheter-spørreskjema [dissertation]. [Bergen]: The University of Bergen; 2018.
8. 8. Campos LCB, Caro CC, Fachin-Martins E, Cruz DMCD. Cross-cultural adaptation and reliability of the Brazilian version of the wheelchair skills test-questionnaire 4.3 for manual wheelchair users. Assist Technol. 2022 Jan 2;34(1):54-60.

9. 9. Kirby RL, Rushton PW, Smith C, Routhier F, Best KL, Boyce J, et al. Wheelchair Skills Program Manual Version 5.0 [Internet]. Nova Scotia: Dalhousie University; 2019 August [cited 2020 May 10]. Available from: https://wheelchairskillsprogram.ca/wp-content/uploads/WSP-Manual-version-5.0-approved-version.3.pdf
10. 10. Walter SD, Eliasziw M, Donner A. Sample size and optimal designs for reliability studies. Stat Med. 1998 Jan 15;17(1):101-10.
11. 11. Kirby RL, Dupuis DJ, Macphee AH, Coolen AL, Smith C, Best KL, et al. The wheelchair skills test (version 2.4): measurement properties. Arch Phys Med Rehabil. 2004 May;85(5):794-804.
12. 12. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000 Dec 15;25(24):3186-91.
13. 13. Eser E, Fidaner H, Elbi H, Fidaner C, Eser SY, Göker E. WHOQOL-100 ve WHOQOL-BREF’in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1999;7(Ek 2): 23-40.
14. 14. Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012 Sep;24(3):69-71.
15. 15. Mekki M, Delgado AD, Fry A, Putrino D, Huang V. Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review. Neurotherapeutics. 2018 Jul;15(3):604-617.
16. 16. Kirby RL, Mitchell D, Sabharwal S, McCranie M, Nelson AL. Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial. PLoS One. 2016 Dec 21;11(12):e0168330.
17. 17. Kirby RL, Swuste J, Dupuis DJ, MacLeod DA, Monroe R. The Wheelchair Skills Test: a pilot study of a new outcome measure. Arch Phys Med Rehabil. 2002 Jan;83(1):10-8.
18. 18. Lindquist NJ, Loudon PE, Magis TF, Rispin JE, Kirby RL, Manns PJ. Reliability of the performance and safety scores of the wheelchair skills test version 4.1 for manual wheelchair users. Arch Phys Med Rehabil. 2010 Nov;91(11):1752-7.
19. 19. Ossada VAY, Souza JG, Cruz DMC, Campos LCB, Medola FO, Costa VSP. Cross-cultural adaptation of wheelchair skills test (version 4.3) for wheelchair users and caregivers to the Portuguese language (Brazil). Disabil Rehabil Assist Technol. 2020 Jul;15(5):491-498.
20. 20. Passuni D, Dalzotto E, F Gath C, Buffetti E, Elizalde M, Jarmoluk V, et al. Reliability of the Spanish version of the wheelchair skills test 4.2 for manual wheelchair users with spinal cord injury. Disabil Rehabil Assist Technol. 2019 Nov;14(8):788-791.
21. 21. Moscoso Alvarado F, Bohórquez Garcia JA, Rincón Ortiz LM, Soto SE, Hernández Alvarez ED. Translation and cross-cultural adaptation of the Wheelchair Skills Test (WST) version 4.3 form from English to Colombian Spanish. Disabil Rehabil Assist Technol. 2020 Jul;15(5):521-527.
22. 22. Kirby RL, Worobey LA, Cowan R, Pedersen JP, Heinemann AW, Dyson-Hudson TA, et al. Wheelchair Skills Capacity and Performance of Manual Wheelchair Users With Spinal Cord Injury. Arch Phys Med Rehabil. 2016 Oct;97(10):1761-9.
23. 23. Dalhousie University. Wheelchair Skills Program (WSP) Manual and Forms [Internet]. Nova Scotia: Dalhousie University, Faculty of Medicine; 2019 August 2 [cited 2023 July 28]. Available from: https://wheelchairskillsprogram.ca/en/manual-and-form-archives/
24. 24. Rushton PW, Kirby RL, Routhier F, Smith C. Measurement properties of the Wheelchair Skills Test-Questionnaire for powered wheelchair users. Disabil Rehabil Assist Technol. 2016;11(5):400-6.