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UBC Theses and Dissertations

A mixed-methods study comparing skill performance between indoor and outdoor environments among experienced scooter users Jang, Sharon Liana


Background: The Wheelchair Skills Test (WST) has been validated to assess scooter users’ skill performance and mobility confidence. Traditionally, the WST has been performed using a standardized indoor course; however, it has been suggested that an outdoor community-based setting may be a suitable alternative. However, no previous research has compared scooter skill performance in an indoor versus outdoor environment. Objectives: 1) To explore participants’ experiences with scooter use, 2) to determine the distribution of WST scores and how scores compare between indoor and outdoor environments, 3) to determine correlations between the indoor lab-based WST scores, the outdoor community-based WST scores, and the WST-Q scores, and explore participants’ perspectives on the representativeness of the WST, testing preferences, and suggestions for improvement, and 4) to determine the practicality of performing the WST in an outdoor community-based setting.. Methods: For this mixed-methods study, 20 scooter users who have used their devices for ≥ 3 months were recruited. Each participant was randomized to complete the WST twice – once in their community and once indoors within a two-week period. While testing in the community, detailed observations were made of the setting and the 28 representative skills on the WST (e.g., curbs, hills). Semi-structured interviews were conducted after completion of the WST in both environments. Results: Indoor and outdoor scores were not strongly correlated (r= 0.306, p=0.190) and demonstrated wide limits of agreement. The outdoor WST scores were weakly correlated with subjective capacity, confidence, performance, and mobility; however, this may have been related to a low variation in scores. When searching for WST obstacles in the community, the majority were easily found. . Whereas most participants preferred performing the WST in their community due to convenience and familiarity, they also perceived the indoor course as reflective of their community setting. Conclusion: These findings suggest that skills testing in the community is feasible; however, skills testing in indoor and outdoor settings are not comparable. Community-based testing may provide a better reflection of day to day performance of experienced users, but may not reflect user’s capacity in novel environments.  

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