Cognitive status is associated with performance of manual wheelchair skills in hospitalized older adults
Bibliographic record
Abstract
PURPOSE: To examine the relationship between manual wheelchair skills and cognitive function in hospitalized older adults. METHODS: The observational study included older adults who used a manual wheelchair following hip/knee surgery. Participants underwent a series of tests to evaluate manual wheelchair skills and cognitive performance. Four items appearing on the Wheelchair Skills Test: brake handling (locking/unlocking), a 10-metre forward roll, a 2-metre backward roll and rotating in place, were used to evaluate manual wheelchair skills. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), the Clock Drawing Test, and the Loewenstein Occupational Therapy Cognitive Assessment. The relationship between wheelchair skills and cognitive scores was assessed by a series of univariate linear regression analyses. RESULTS: Fifty older adults, aged 65-85, participated in the study. The MoCA-7 (orientation) explained 19.3% of the variance related to the turn in place wheelchair skill, 18.8% of the variance related to the two-metre backwards roll and 31.9% of the variance related to the 10-metre forward roll. The addition of gender (to the MoCA-7) increased the explained variance related to the 10-metre forward roll and turn in place skills to 38.5% and 28.5%, respectively. As for the brakes handling skill test, gender explained 18.3% of the variance. The addition of the CDT (to gender) increased the explained variance for the brakes handling skill to 31.4%. CONCLUSIONS: Because cognitive impairments negatively affect the performance of wheelchair skills, rehabilitation therapists may need to adjust wheelchair mobility training methods for cognitively impaired older adults.Implication for rehabilitationGiven the prevalence of older adults with cognitive impairments who use manual wheelchairs, it is critical to better understand the relationship between cognition and wheelchair skills.Poor results reported on the cognitive tests, specifically, visual attention and orientation, were found to be associated with poor performance of four manual wheelchair skills.Rehabilitation therapists should consider the cognitive status of older adults when teaching manual wheelchair skills, specifically in new users. Future studies should examine whether a customized preparation program, enhancing visuospatial orientation, can benefit manual wheelchair control in older adults.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".