Investigating the Reliability and Validity of Three Novel Virtual Reality Environments With Different Approaches to Simulate Wheelchair Maneuvers.

Wheelchair manoeuvring has received little attention in the literature despite its importance in mobility and performing activities of daily living and its role in developing secondary injuries for wheelchair users. The focus in this paper was technology development with iterative and proof-of-concept testing. Three versions of a wheelchair simulator that were designed and developed for simulating curvilinear wheelchair propulsion in virtual reality were tested for their validity and reliability. The wheelchair simulators comprise a sophisticated wheelchair ergometer in an immersive virtual reality environment and are developed for manual wheelchair propulsion. These simulators all replicate inertia in translation, in addition to taking three approaches for simulating turning. The three systems were then tested and compared with the real world to see how reliable and valid they are; 15 healthy participants were recruited to perform the Illinois Agility Test (IAT) in two sessions that were at least one week apart. The intraclass correlation coefficient and the Pearson correlation coefficient were found for 16 variables to find the test-retest reliability and convergent construct validity of the systems, respectively. Overall, the three systems showed good validity and reliability with the VR_system 2 (mechanical compensation for rotational inertia) having the best scores and the VR_system 3 (software compensation for rotational inertia) having the lowest scores. Also, it was observed that performing IAT in the real world needed fewer pushes and often accompanied more negative pushes. Participants also used longer strokes in the real world compared to virtual reality environment.