Getting a Manual Wheelchair Over a Threshold Using the Momentum Method: A Descriptive Study of Common Errors

Objectives To (1) document the success of learners' attempts to overcome a threshold in a manual wheelchair while using the momentum method; (2) describe the frequency and nature of any errors observed; and (3) compare the characteristics of participants who were or were not successful on their first attempts. Design Cross-sectional, observational study following Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Setting Indoor obstacle course in a rehabilitation center. Participants Able-bodied students (N=214) learning the threshold skill. Intervention Participants attempted to get over the Wheelchair Skills Test (WST) threshold (2cm high, 1.5m wide, and 10cm in the line of progression) in a manual wheelchair. Main Outcome Measures From each participant's video recording of the first attempt, we assigned a WST score for the skill and described any errors noted. Results The WST scores for the first attempts were “pass” for 16 (7.5%), “pass with difficulty” for 100 (46.7%), and “fail” for 98 (45.8%). Eventually, requiring up to 6 attempts, 203 participants (94.9%) were successful (pass or pass with difficulty). Twenty-six different error types were identified. With the use of logistic regression analysis, the odds ratio of failing on the first attempt for women versus men was 2.71 (95% confidence interval, 1.23–6.00) (P=.0138). Conclusions Only about half of able-bodied people learning the threshold skill using the momentum method are successful on their first attempts, although almost all are successful with further practice and feedback. During the first attempts, there are a wide variety of errors, primarily in the popping phase of the skill. Those who are successful on their first attempts are more likely to be men. These findings have implications for the assessment and training of the threshold skill.