Outcome measures for wheelchairs and seating

Why should we use outcome measures in wheelchair and seating services?

Outcome measurement is considered best practice and supports equitable, person-centred access (World Health Organization, 2023, p.49).

Outcome measures can:

• Guide goal setting and structure meaningful discussions with wheelchair users

• Demonstrate changes in function and participation with and without a wheelchair

• Measure progress following wheelchair training

• Support comparisons during wheelchair trials

• Provide justification for wheelchair funding

• To help contribute to research and service development (Lange & Minkel, 2025, p.671).

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Wheelchair Outcomes Assessment Tool for Children (WATCh) and Wheelchair Outcomes Assessment Tool for Adults (WATCh-Ad)

What are the WATCh and WATCh-Ad assessment tools?

The WATCh was developed using a mixed-method study of surveys and interviews with young wheelchair users and their parents in the United Kingdom (Tuersley et al., 2018). It was designed for use with children and young people aged 18 and under, and later adapted for adults as the WATCh-Ad.

These tools are person-centred outcome measures based on 16 predefined life areas, with an optional additional area.

They are designed to be used before wheelchair provision and three to six months after a wheelchair has been provided.

In Parts A and B, wheelchair users are asked to select their five most important life areas. They then rank the life areas and describe what they want to achieve and rate their current level of satisfaction using a five-point Likert scale ranging from “very dissatisfied” to “very satisfied.”

Part C involves re-rating satisfaction after receiving equipment (Tuersley et al., 2025).

Advantages of the WATCh and WATCh-Ad

• Covers body functions, activity, participation, carer wellbeing, and psychological health.

• Incorporates areas that may not always be covered by funding criteria and/or included in initial wheelchair discussions.

• Supports wheelchair users who may find goal setting difficult by providing prompts.

• Is comparable in completion time to other quick outcome measures.

• Has good useability. In a recent study, 81% of wheelchair users found the tool easy to understand, and 75% reported no problems using it (Tuersley et al., 2025, p.10).

Limitations of the WATCh and WATCh-Ad

• Multiple parts may make the process feel complex for some people.

• Does not explicitly distinguish indoor vs outdoor mobility (unlike the Wheelchair Outcome Measure /WhOM).

• The evidence base is currently largely UK based.

• May be less familiar to clinicians/EMS assessors working in New Zealand.

• Handy tips when using the WATCh and WATCh-Ad

• Consider sending the tool to wheelchair users before the appointment.

• The authors suggest that selecting only three to five key areas can be sufficient if time is limited, and/or people are struggling to identify five.

• Use a spreadsheet to support interpretation (this is available from the Enable NZ wheelchair and seating outreach team).

You can access information and the assessment tools online at https://www.bangor.ac.uk/cheme/watch-the-wheelchair-outcomes-assessment-tools, or obtain a word version adapted with permission for the Mobility for Life Research Project at enable.co.nz/mobility-for-life.

The WATCh/WATCh-Ad can help structure goal setting and demonstrate outcomes pre- and post-provision.

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References

Lange, M. L., & Minkel, J. L. (Eds.). (2025). Seating and Wheeled Mobility: A Clinical Resource Guide (2nd ed.). Routledge.

Tuersley, L., Bray, N., & Tudor Edwards, R. (2018). Development of the wheelchair outcomes assessment tool for children (watch): A patient-centred outcome measure for young wheelchair users. PLoS ONE, 13(12). https://doi.org/10.1371/journal.pone.0209380

Tuersley, L., Quaye, N. A., Pisavadia, K., Edwards, R. T., & Bray, N. (2025). Use of patient-centred outcome measures alongside the personal wheelchair budget process in NHS England: A mixed methods approach to exploring the staff and service user experience of using the WATCh and WATCh-Ad. PLoS ONE, 20(1 January). https://doi.org/10.1371/journal.pone.0312967

World Health Organization. (2023). Wheelchair provision guidelines. https://doi.org/https://www.who.int/publications/i/item/9789240074521