Wheelchair Skills Test (WST)

Assessment Overview
Assessment Area Summary
ICF Domain: The Wheelchair Skills Test (WST) is a performance-based measure designed to
Activity objectively evaluate manual wheelchair skills and safety. There are multiple
Subcategory: versions of this measure for manual chairs, powered chairs, and scooters, for
Mobility both wheelchair users and their caregivers. The WST may be administered by a
tester/trainer that supervises and scores the test or in self-report/questionnaire
form (WST-Q).
You Will Need
As of August 2016, the latest revision of the WST is version 4.3.3. The
Administration:
Wheelchair Skills Test assesses the level of wheelchair skills required for daily
 Approximately 30 minutes to functioning. The WST can be used during the initial provision of the
complete 34 Tasks (Manual) or wheelchair and as necessary at follow-up. The materials are
30 Tasks (Power) (Standard continuously being updated for free so visit
Version). www.wheelchairskillsprogram.ca for any updates.
 Approximately 10 minutes to
complete 34 Tasks (Manual) or
30 Tasks (Power)
(Questionnaire version).
 It may be necessary to have a Availability
spotter in addition to the
tester/trainer for supervision Download here:
and safety. http://www.wheelchairskillsprogram.ca/eng/testers.php
Scoring
 Each skill is scored from 0-2 As of August 2016, the current version is 4.3.3 and a full instruction manual are
(Fail = 0; Pass with Difficulty or available at:
Assistance = 1; Pass = 2) http://www.wheelchairskillsprogram.ca/eng/documents/version4.3.3/The_Whe
 Some skills may be marked NP elchair_Skills_Program_Manual.77_w_comments_and_highlights.pdf
(Not Possible); they can be
subtracted from the Available in: English, French (www.wheelchairskillsprogram.ca/fre).
denominator to avoid affecting
the Total Score
 The tester should also record
any comments that are
instructive (e.g. the reasons for
any task failures, left-right
asymmetry).
 To get a percentage WST
Capacity Score add up all
scores, divide by number of
skills attempted and multiply
by 2 (and 100%).
Equipment:
 Approximately 1000 square
feet of space
 A standardized wheelchair
circuit or access to a variety of
natural barriers (e.g. ramps,
curbs, potholes, etc.)
Assessment Interpretability

Minimal Clinically Important Statistical Error Typical Values

Difference
Not established in SCI Not established in SCI Mean total score:

All participants: 80.7±11.8

Tetraplegia: 72.1±7.9

High paraplegia: 82.8±9.1

Low paraplegia: 84.0±12.4

55.6% of participants scored over

80% (considered the cut-off for
distinguishing people with
advanced MWC skills (e.g. skills
required to control wheelies))
(Lemay et al., 2011; N=54, 41 male)
Measurement Properties

Validity – Moderate to High Reliability – Moderate to High

Moderate correlation with wheeled distance per day: Moderate to High Test-retest Reliability:

Pearson’s r = 0.36 ICC = 0.84~0.94 (For measured speeds; Pradon et al., 2012; N=40, 30 male)

Moderate negative correlation with age: Spearman’s ρ = 0.65 (Kirby et al., 2002; N=24, 16 male, 3 SCI)

Pearson’s r = -0.32 (Lemay et al., 2011; N=54, 41 male) ICC = 0.91 (for v.4.1 with Manual Wheelchairs: Lindquist et al., 2010;)

Predictive validity: Moderate to High Inter-rater Reliability:

WST predicts CHART and SWLS scores (Hosseini et al., 2012; ICC = 0.92~0.95 (For measured speeds; Pradon et al., 2012; N=40, 30 male)
N=214)
Spearman’s ρ = 0.95 (Kirby et al., 2002; N=24, 16 male, 3 SCI)
Moderate Concurrent validity with admission and
ICC = 0.855 (for MWC v.4.1: Lindquist et al., 2010; N=11, SCI = 9)
discharge FIM scores:
High Intra-rater Reliability:
Spearman’s ρ = 0.38 and 0.31. (Kirby et al., 2004; N=298; only 11%
SCI – others are ABI, Stroke, Amputees, musculoskeletal conditions) Spearman’s ρ = 0.96 (Kirby et al., 2002; N=24, 16 male, 3 SCI)

Intra-rater = 0.950 (for Manual Wheelchairs v.4.1: Lindquist et al.,

Number of studies reporting validity data: 7 2010; N=11, SCI = 9)

High Internal Consistency:

High Concurrent validity between the WST and the
WST-Q: Cronbach’s α = 0.90 (Rushton et al. 2016; N = 72; 36 males, Mean age
60.7 (7.3) SCI = 19% of study population)
Pearson’s r = 0.65 (Rushton et al. 2016; N = 72; 36 males, Mean age
60.7 (7.3) SCI = 19% of study population)
Number of studies reporting reliability data: 5

Responsiveness
Floor/Ceiling Effect: Effect Size: Number of studies reporting
Not established in SCI The SEM and SRD were 5.0 and 6.2 responsiveness data: 0
respectively.
(Rushton et al. 2016; N = 72; 36 males, Mean age
60.7 (7.3))