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The FABS/M includes 61 questions, 133 items and six domains including the type of primary mobility device; built features of homes; built and natural features in the community; community destination access; community facilities access; community support network. Environmental items are scored for the frequency of encounter and the magnitude of influence on their participation. The internal consistencies and the test-retest reliabilities of the domains of the FABS/M ranged from low to moderate. The discriminant validity of domains differed for device and diagnostic groups. CONCLUSION. The FABS/M joins the MQE and the CHIEF as another subjective measure for use in assessing environmental features important for understanding participation. The FABS can be used to assess the influence of environmental interventions at the individual and community levels of analysis. The type of primary mobility device that is used can be related to reported environmental barriers. Community-based improvements in built features, access to destinations, access to facilities and augmented support networks can be tracked through the reports of people with mobility impairments.

Verbal training may produce changes in push biomechanics of manual wheelchair users. Longer training periods may be needed to sustain propulsion changes. Findings from this study support other studies that have shown propulsion differences between people with tetraplegia and paraplegia. Propulsion training for populations with upper-extremity impairments warrants further study.

Some mobility device skills used in controlled environments appear to transfer to community settings; others do not. Skills required for community participation may partially depend on mobility device used.

The CHEC offers a brief, easily administered measure of receptivity of the physical environment for persons with mobility impairments that is psychometrically sound.

Researchers have used several types of testing devices and training surfaces to examine wheelchair propulsion. Testing and training wheelchair users on the actual surface of interest, such as tile floors or ramps, is ideal but difficult. Devices such as treadmills, dynamometers, and ergometers allow for researchers and clinicians to observe wheelchair users in a controlled space. However, these devices often do not have the ability to realistically simulate the environment. This methodological article describes the instrumentation, development and function of a wheelchair dynamometer system, the WheelMill System (WMS), a uniquely adjustable roller system for wheelchairs. Three participants wheeled on the WMS, over a tile surface and up two different graded slopes with the SmartWheel to compare speed and forces. The WMS reasonably simulated propulsion over a tile floor, though the participants' speed was slightly faster on tile, and the peak forces for each propulsion stroke varied more on tile than on the WMS. For the slopes, the speed oscillated over a greater range and was slower, and the measured peak forces were higher than the values measured on the WMS. The WMS may have several applications, though additional studies on a greater and more diverse population are needed.

Identifying essential components for training the proper propulsion mechanics and wheelchair skills in new manual wheelchair users is an important step in preventing future health and participation restrictions. Implications for Rehabilitation Wheelchair skills are being addressed frequently during rehabilitation at the activity-dependent level. Propulsion techniques, transfers in an out of the wheelchair, providing maintenance to the wheelchair and navigating barriers such as curbs, ramps and rough terrain are important skills to address during wheelchair training. Environment factors (in the home and community) are important to incorporate into wheelchair training to maximize safe and multiple-environmental-setting uses of manual wheelchairs. The ICF has application to understanding manual wheelchair rehabilitation for wheelchair users and therapists for improving the understanding of manual wheelchair use.