Test-Retest Reliability and Minimal Detectable Change of the SmartWheel Clinical Protocol

December 2012
Publication year: 2012
Source:Archives of Physical Medicine and Rehabilitation, Volume 93, Issue 12



Lui J, MacGillivray MK, Sawatzky BJ. Test-retest reliability and minimal detectable change of the SmartWheel clinical protocol. Objectives (1) To quantify the intra- and intersession reliability and minimal detectable change (MDC) of the SmartWheel clinical protocol (SCP) and (2) to compare the reliability of the SCP between experienced and naïve wheelchair users. Design Test-retest study. Setting Biomechanics laboratory. Participants Manual wheelchair users (WCUs) (n=10) with 1 to 32 years of wheeling experience and able-bodied (AB) naïve users (n=15). Interventions Not applicable. Main Outcome Measures Wheelchair propulsion parameters including average peak force, push frequency, push length, and velocity were measured according to the SCP but with 5 trials per session, for 2 sessions. WCUs and AB users were analyzed separately. Intraclass correlation coefficients ([ICC]2,1 and ICC2,5) were calculated to assess intrasession reliability. ICC2,1 and MDC (with 95% confidence) were calculated for each SCP parameter using a single trial from each session and with the mean of 5 repeated measures to evaluate intersession reliability. Results Intra- and intersession reliability for WCU parameters ranged from high to very high correlation (ICC range, .70–.99). For AB parameters, intrasession ICC2,1 ranged from moderate to very high (ICC range, .50–.92), while intersession ICC2,1 indicated low to very high correlation (ICC range, .25–.90). Estimates of standard error of measurement and MDC were provided for each parameter. For both WCUs and AB users, using the means from 5 trials increased intra- and intersession ICC and decreased MDC values. All MDC values were lower for WCUs compared with AB users. Conclusions The SCP is a reliable method for assessing propulsion parameters in WCUs, even if just 1 trial is taken per session. AB users showed lower intra- and intersession reliability compared with WCUs. Therefore, for AB users or individuals with minimal wheeling experience, averaging multiple trials is recommended for the SCP.

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