Responsiveness of the TAWC tool for assessing wheelchair discomfort.

PURPOSE The purpose of this research was to determine the clinical usefulness of the Tool for Assessing Wheelchair disComfort (TAWC) by examining floor and ceiling effects and responsiveness when used with two groups of wheelchair users--one known to have experienced real changes in discomfort levels and the other with unchanged levels. METHOD In a retrospective analysis of data from two previous studies, change scores were compared across two groups of subjects--one stable group (NON-CHANGERS) and one experiencing a seating intervention (CHANGERS) intended to decreased seating discomfort. RESULTS No significant floor or ceiling effects were found. The average General Discomfort Score (GDS) change among the NON-CHANGERS was 2.0 (with a possible score range of 13-91) and average Discomfort Intensity Score (DIS) change was 1.8 (with a possible score range of 8-99) for the same group. Conversely, average GDS change among the CHANGERS was 8.7 and the average DIS change was 7.7. Additionally, both scores demonstrated a moderate effect size (d) for two tested treatments (GDS = 0.53 and 0.50, DIS = 0.31 and 0.33) and the standardized response means were 0.78 and 0.77 for the GDS and 0.80 and 1.2 for the DIS. CONCLUSIONS All analyses indicate good responsiveness of the TAWC, supporting its use clinically and in future research.