Development of a Classification System for Wheelchair Maintenance and Seat Positioning

Background/Purpose: Developing a producer-independent, transparent, and clinically based classification for seat and wheelchair supply (Wheelchair Function Classification System, WFCS).

Methods: Based on expert knowledge, a classification system was created, consisting of 10 clinical examination findings. Each clinical finding is evaluated between 1 and 5 points. From this evaluation, five classification levels are formed. Level I is independent from scoring (sports wheelchair). Levels II to V are divided into adapted wheelchair with self-propulsion (III) up to seat shell provision (V). The reliability was tested on 58 patients (38/20 m/f), mean age 10.3 years. Two teams retrospectively compared the validity by checking the actual wheelchair supply and the theoretically WFCS-based recommendation for a wheelchair.

Results: The analysis was complicated due to partially incomplete clinical data. The WFCS classification came off unfailing with a mean difference in assessment of 0.15 concerning the group of patients with completed clinical data and 0.92 in analyzing all patients (including incomplete data). The interrater reliability was confirmed by W = 0.87 (complete data, Kendall’s concordance coefficient).

Conclusion: The WFCS allows a reliable, transparent, clinical-data-based, producer-independent and medical backed-up maintenance with wheelchair and seat-shell. Further steps in development needed to be done (e.g., expansion of data-base, analysis of sub-groups) before a wider use can be recommended.