Concordance of Self-Report and Performance-Based Measures of Function and Differences between Clinic and Home among Wheelchair Users

Abstract

Objective: The main objective of this study was to investigate concordance and differences among self-report and performance-based measures for wheelchair users. Method: The Functioning Everyday with a Wheelchair (FEW); a self-report measure, the FEW-Capacity (FEW-C); a performance-based measure for the clinic and the FEW-Performance (FEW-P) that measures clients’ skills in the home were the measures used in this study. We examined the concordance of the FEW and the FEW-C with the FEW-P as the criterion measure, and investigated the differences between the FEW-C and the FEW-P at pretest and posttest following the provision of a new wheeled mobility and seating device. Results: Our results suggested that the FEW-C was most concordant with the FEW-P for majority of the items compared to the FEW. At both pretest and posttest, for most of the tasks, the FEW-C and FEW-P were comparable suggesting that the environment may have a neutral effect. However, at posttest, the clients’ safety scores for the outdoor mobility task and the clients’ quality scores for the Personal Care task improved significantly suggesting that the standard supportive environment of the clinic may have enabling effect on activity performance. Conclusion: Clinically, rehabilitation clinicians may get a more accurate estimation of functional performance in the home from a clinic assessment, and they are cautioned that the inclusion of self-report assessment and data obtained from clients’ perceptions may be discrepant with actual performance. We also concluded that the impact of the environment on activity performance of wheelchair users can be neutral or enabling depending on time of assessment and tasks being assessed.