Purpose
The 4FTPSMW quantifies functional ability when manual wheelchair users employ different postural supports.
Link to Instrument
Acronym
4FTPSMW
Primary Image
4 Functional Tasks for Wheelchairs
Expertise, Instruction and Mentorship
Center for Smart Use of Technologies to Assess Real World Outcomes (C-STAR)
Upcoming Stroke Course
May 9–10
Live and Online
Offered by Academy, Shirley Ryan AbilityLab
Populations
Key Descriptions
- Four skills:
- 1) Timed forward wheeling : distance=23 m plus length of wheelbase.
- 2) Forward vertical reach: individuals hold a 1 meter measuring stick in both hands with palms facing down, starting position is forearms parallel to thighs and raise the measuring stick up. The distance measure was from the floor to the highest point reached.
- 3) Ramp ascent (forward wheeling): The ramp was 10.3m long with a grade of 1:13. Participants were given a moving start of 4.5 meters on a level surface. Timing began when the front casters crossed the start line at the beginning of the incline and continued until the most posterior aspect of the rear wheel crossed the finish line at the top of the ramp.
- 4) One-stroke push: all four wheels positioned on carpet (1.5 cm pile). Participant propelled wheelchair forward by pushing once with maximal effort. Distance was measured by choosing the most posterior point of the rear wheel before and after propulsion.
- Individuals use their current wheelchair and back support.
- Recommend adequate rest breaks between each skill to avoid upper extremity fatigue.
Number of Items
4
Equipment Required
- Stop watch
- Tape measure
- Meter stick
- Ramp (10.3, 1:13 grade)
- Carpet (1.5cm pile)
- Patient's manual wheelchair
Time to Administer
30 minutes
30 Minutes to Complete 2 Trials
Required Training
No TrainingInstrument Reviewers
Initially reviewed by Irene Ward, PT, DPT, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 6/2012.
ICF Domain
ActivityMeasurement Domain
MotorProfessional Association Recommendation
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
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SCI EDGE |
NR |
NR |
NR |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
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TBI EDGE |
NR |
NR |
NR |
NR |
NR |
Recommendations based on SCI AIS Classification:
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AIS A/B |
AIS C/D |
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SCI EDGE |
NR |
NR |
Recommendations for use based on ambulatory status after brain injury:
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Completely Independent |
Mildly dependant |
Moderately Dependant |
Severely Dependant |
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TBI EDGE |
N/A |
N/A |
N/A |
N/A |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
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SCI EDGE |
No |
No |
No |
Not reported |
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TBI EDGE |
No |
No |
No |
Not reported |
Considerations
- This measure lacks rigorous psychometric testing. This review is based off of one article. No information specific to TBI was found in the review process.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Wheelchair Usage
back to PopulationsNormative Data
Manual wheelchair users: (May et al, 2003, n=9 for reliability testing, average age=33.1 years, range 23-70 years, male, all had a neurological condition affecting the spinal cord, all but 2 had been wheelchair dependent for less than 2 years)
- Forward wheeling (seconds)- trial 1, trial 2
- Average score= 14.7, 14.6
- Standard deviation= 8.2, 7.3
- Minimum=6.9, 6.6
- Maximum= 34.3, 31.0
- Forward vertical reach (cm)- trial 1, trail 2
- Average score= 160.7, 160.8
- Standard deviation= 9.1, 10.1
- Minimum=147.4, 145.6
- Maximum= 172.3, 173.6
- Ramp ascent (s)- trial 1, trial 2
- Average score= 39.6, 34.4
- Standard deviation= 81.7, 70.1 (one participant need frequent rests)
- Minimum=3.2, 3.2
- Maximum= 255.1, 219.9
- One-stroke push (cm)- trial 1, trial 2
- Average score= 102.1, 109.8
- Standard deviation= 38.4, 40.6
- Minimum= 45.7, 47.7
- Maximum= 175.5, 188.7
Test/Retest Reliability
Manual wheelchair users: (May et al, 2003, n=9 for reliability testing, average age=33.1 years, range 23-70 years, male, all had a neurological condition affecting the spinal cord, all but 2 had been wheelchair dependent for less than 2 years)
- Excellent test-retest reliability of all 4 functional tasks (r=.99, P<.001)
Interrater/Intrarater Reliability
Manual wheelchair users: (May et al, 2003, n=9 for reliability testing, average age=33.1years, range 23-70 years, male, all had a neurological condition affecting the spinal cord, all but 2 had been wheelchair dependent for less than 2 years)
- Excellent interrater reliability for three of the four tasks, (ICC=.99, P<.001). The one-stroke push was added to replace one of the original four tasks, the ramp descent. Therefore, the interrater reliability for the one-stroke push was not calculated.
Content Validity
The four functional skills were chosen by a panel of clinicians with more then 5 years of experience, a clinical researcher, and clients.
Bibliography
May, L. A., Butt, C., et al. (2004). "Wheelchair back-support options: functional outcomes for persons with recent spinal cord injury." Arch Phys Med Rehabil 85(7): 1146-1150. Find it on PubMed
May, L. A., Butt, C., et al. (2003). "Measurement reliability of functional tasks for persons who self-propel a manual wheelchair." Arch Phys Med Rehabil 84(4): 578-583. Find it on PubMed