Reliability of the Test of Wheeled Mobility (TOWM) and the Short Wheelie Test

Objective: To assess the reliability of the Test of Wheeled Mobility (TOWM) and the Wheelie test. Design: Cohort study. Setting: Gymnasium. Participants: Manual wheelchair users (N=30, age 23-53y) with a spinal cord injury. Intervention: Participants performed the 30 skills of the TOWM and the 8 skills of the Wheelie test twice. Ability, time, and anxiety scores were assessed on field. Quality scores were assessed by video analysis. Main Outcome Measures: Test-retest reliability was evaluated for the ability, time, anxiety, and quality scores of both tests. Intrarater and interrater reliability were determined on the basis of quality scores of 20 participants. Intraclass coefficient and nonparametric statistics were applied, as well as standard error of measurement, method error (ME), coefficient variation of ME, minimal detectable change (95% confidence), and technical error of measurement. Results: Test-retest reliability: no significant differences between t1 and t2 in the ability, quality, and time scores, except for anxiety scores. Standard error of measurement, ME, coefficient variation of ME, and minimal detectable change (95% confidence) values were low for the ability and quality total score and higher for the time and anxiety total score. Intrarater and interrater reliability interclass correlation coefficients of both tests ranged between .91 and .99. Interrater relative technical error of measurement for the TOWM and the Wheelie test total quality score was 3.7% and 6.3%, respectively, and intrarater relative technical error of measurement was 4.3% and 6.1%, respectively. Interclass correlation coefficients per individual tasks ranged between .88 and 1.00, except for "level propulsion forward," which showed low interclass correlation coefficient scores (interrater: .49; intrarater: .44; test-retest: .43). Conclusions: Based on ability and quality total scores, the TOWM and the Wheelie test are reliable when assessing the wheeled mobility of manual wheelchair users with spinal cord injury. The quality criteria of 1 task from the TOWM and 3 tasks from the Wheelie test need to be refined. Archives of Physical Medicine and Rehabilitation 2013;94:761-70 (C) 2013 by the American Congress of Rehabilitation Medicin