Sage Journals: Discover world-class research

Abstract

Objective: To develop and validate a statistical model to predict wheelchair skills at discharge (t₂) from personal and lesion characteristics and wheelchair skills at the start of spinal cord injury inpatient rehabilitation (t₁).

Design: Prospective cohort study

Setting: Eight Dutch rehabilitation centres.

Subjects: One hundred and forty-two patients with a spinal cord injury.

Main measures: Models were developed with the performance time and ability score at t₂ as dependent variables and t₁ scores of performance time and ability score, age, gender, body mass index, level and completeness of the lesion as independent variables. The statistical models were evaluated by comparing individual estimated scores with actual measured scores.

Results: The main independent variables to predict wheelchair skills at discharge were the t₁ performance time and ability score, age, gender and lesion level. The intraclass correlation coefficient between the estimated and actual ability score was 0.79 and for the performance time 0.86. However, the 95% limits of agreement and their confidence intervals were relatively wide for both ability score (—2.3 to 3.4, range 0—8) and performance time (—12.5 to 8.2, range 11—40 seconds).

Conclusion: The prognostic models developed in this study to predict future wheelchair skills might help planning the course of rehabilitation. The models should be used with caution in daily clinical practice, but may add useful information to clinical expertise and knowledge of the individual patient.

Get full access to this article

View all access options for this article.

References

Post MW , van Asbeck FW , van Dijk AJ , Schrijvers AJ Services for spinal cord injured: availability and satisfaction. Spinal Cord 1997; 35: 109-15.

WHO. International classification of functioning, disability and health, 2009. Accessed from http://www.who.int/classifications/icfbrowser/.

Noreau L. , Shephard RJ Spinal cord injury, exercise and quality of life. Sports Med 1995; 20: 226-50.

MacPhee AH , Kirby RL , Coolen AL , Smith C. , MacLeod DA , Dupuis DJ Wheelchair skills training program: a randomized clinical trial of wheelchair users undergoing initial rehabilitation. Arch Phys Med Rehabil 2004; 85: 41-50.

Kilkens OJ , Dallmeijer AJ , Angenot E. , Twisk JW , Post MW , Van Der Woude LH Subject- and injury-related factors influencing the course of manual wheelchair skill performance during initial inpatient rehabilitation of persons with spinal cord injury. Arch Phys Med Rehabil 2005; 86: 2119-25.

Newton AM , Kirby RL , MacPhee AH , Dupuis DJ , MacLeod DA

Evaluation of manual wheelchair skills: is objective testing necessary or would subjective estimates suffice?

Arch Phys Med Rehabil 2002; 83: 1295-99.

Kilkens OJ , Post MW , Van Der Woude LH , Dallmeijer AJ , van den Heuvel WJ The wheelchair circuit: reliability of a test to assess mobility in persons with spinal cord injuries. Arch Phys Med Rehabil 2002; 83: 1783-88.

Kilkens OJ , Dallmeijer AJ , De Witte LP , Van Der Woude LH , Post MW The Wheelchair circuit: construct validity and responsiveness of a test to assess manual wheelchair mobility in persons with spinal cord injury . Arch Phys Med Rehabil 2004; 85: 424-31.

Kirby, R.L. , Dupuis DJ , MacPhee AH et al. The Wheelchair Skills Test (version 2.4): measurement properties . Arch Phys Med Rehabil 2004; 85: 794-804.

10.

de Groot S. , Dallmeijer AJ , Post MW , van Asbeck FW , Nene AV , Angenot EL , Van Der Woude LH Demographics of the Dutch multi-center prospective cohort study ‘Restoration of mobility in spinal cord injury rehabilitation . Spinal Cord 2006; 44: 668-75.

11.

de Groot S. , Dallmeijer A. , Kilkens O. , Post M. , Van der Woude LHV. Patient monitoring during spinal cord injury rehabilitation. Paper presented at the 44th Annual Scientific Meeting of ISCoS Munich, Germany, 2005.

12.

Haisma JA , van der Woude LH , Stam HJ et al. Prognostic models for physical capacity at discharge and 1 year postdischarge from rehabilitation in persons with spinal cord injury. Arch Phys Med Rehabil 2007; 88: 1694-703.

13.

Marino R. , Ditunno Jr J. , Donovan W. et al. International standards for neurological classification of spinal cord injury. Chicago, IL, American Spinal Injury Association, 2000.

14.

Vincent WJ Statistics in kinesiology, second edition. Champaign, IL , Human Kinetics, 1999.

15.

van de Port I. , Kwakkel G. , Schepers VP , Lindeman E. Predicting mobility outcome one year after stroke: a prospective cohort study. J Rehabil Med 2006; 38: 218-23.

16.

Rankin G. , Stokes M. Reliability of assessment tools in rehabilitation: an illustration of appropriate statistical analyses. Clin Rehabil 1998; 12: 187-99.

17.

Bland JM , Altman DG Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307-10.

18.

Mantha S. , Roizen MF , Fleisher LA , Thisted R. , Foss J. Comparing methods of clinical measurement: reporting standards for bland and altman analysis. Anesth Analg 2000 ; 90: 593-602.

19.

Vinet A. , Le GD , Bouges S. , Bernard PL , Poulain M. , Varray A. , Micallef JP Prediction of VO2peak in wheelchair-dependent athletes from the adapted Leger and Boucher test. Spinal Cord 2002; 40: 507-12.

20.

Bruton A. , Conway J. , Holgate S.

Reliability: what is it, and how is it measured?

Physiotherapy 2000; 86: 94-99.

21.

ZonMw Rehabilitation program. Physical strain, work capacity and mechanisms of restoration of mobility in the rehabilitation of individuals with spinal cord injury (SCI). Accessed from www.scionn.nl.

22.

Kilkens OJ , Dallmeijer AJ , Nene AV , Post MW , Van Der Woude LH The longitudinal relation between physical capacity and wheelchair skill performance during inpatient rehabilitation of people with spinal cord injury. Arch Phys Med Rehabil 2005; 86: 1575-81.

Development and validation of prognostic models designed to predict wheelchair skills at discharge from spinal cord injury rehabilitation

Abstract

Get full access to this article

References