The Wheelchair Skills Test Questionnaire (WST-Q), Version 4.3, specifically designed for people who operate scooters, offers a detailed framework for evaluating a user’s ability to safely and effectively utilize their mobility device. This comprehensive form not only assesses individual skills ranging from basic operation to more complex maneuvers but also gauges the user's confidence in performing these tasks and determines if further training is needed. Skills such as turning the power on and off, selecting drive modes and speeds, rolling forwards and backwards, ascending and descending inclines, and getting over thresholds are evaluated on a scalable system. Each task is scored to reflect both the user's capacity and performance, with additional notes on the user's goal and whether additional training should be considered to enhance proficiency. This tool facilitates a structured approach to identify specific areas of difficulty or concern, thereby enabling users, trainers, or caregivers to develop targeted strategies to improve wheelchair use. Initiated and approved for distribution on November 9, 2015, the current version of this form remains a pivotal resource for individuals relying on scooters for mobility, ensuring they are equipped with the necessary skills for navigation and independence. Details and general comments sections further personalize the evaluation, with options to share results with relevant parties, underscoring the form's utility in fostering communication between wheelchair users and their support networks.
| Question | Answer |
|---|---|
| Form Name | Wheelchair Skills Test Form |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 125 |
| Avg. time to fill out | 25 min 30 sec |
| Other names | power operated vehicle assessment maneuver test, Scooters, WSP, wst |
Wheelchair Skills Test Questionnaire
Scooters Operated by Their Users
Name of the wheelchair user: ___________________________ Date: ______________
Person completing questionnaire (if not user): _________________________________
Relationship between the wheelchair user and the person who helped him/her: _______
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Individual Skill |
Capacity |
Confidence |
Performance |
Training |
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Goal? (Y/N) |
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1 |
Moves controller away and back |
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2 |
Turns power on and off |
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3 |
Selects drive modes and speeds |
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4 |
Operates body positioning options |
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5 |
Disengages and engages motors |
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6 |
Operates battery charger |
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7 |
Rolls forwards short distance |
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8 |
Rolls backwards short distance |
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9 |
Turns in place |
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10 |
Turns while moving forwards |
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11 |
Turns while moving backwards |
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12 |
Maneuvers sideways |
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13 |
Reaches high object |
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14 |
Picks object from floor |
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15 |
Level transfer |
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16 |
Gets through hinged door |
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17 |
Rolls longer distance |
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18 |
Avoids moving obstacles |
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19 |
Ascends slight incline |
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20 |
Descends slight incline |
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21 |
Ascends steep incline |
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22 |
Descends steep incline |
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23 |
Rolls across |
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24 |
Rolls on soft surface |
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25 |
Gets over threshold |
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26 |
Gets over gap |
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27 |
Ascends low curb |
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28 |
Descends low curb |
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29 |
Gets from ground into wheelchair |
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Total scores: |
% |
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Originally approved for distribution and use: November 9, 2015; Current version: November 9, 2015
General comments:
Training goals described by the wheelchair user, other than those noted for specific skills:
Name and address of any person(s) to whom the test subject would like a copy of the report to be sent.
Details about the WST can be found in the WSP Manual at www.wheelchairskillsprogram.ca.
Originally approved for distribution and use: November 9, 2015; Current version: November 9, 2015