The Wheelchair Skills Test (WST) evaluates 33 individual skills on capacity, confidence, performance, and whether each is a training goal. For each skill, the user rates their ability on a scale of 0 to 3. Total scores are calculated for capacity, confidence, and performance by summing individual scores and converting to a percentage. The questionnaire is intended to identify training needs and measure improvements in wheelchair skills over time. Six Minute Push Test (6MPT) is a standard clinical protocol that is widely recognized in assessing physical and cardiovascular fitness for Manual Wheelchair Users (MWUs). It is typically performed as a single 6-minute trial per participant and considered sufficient for assessing physical fitness. In a long hallway with a smooth, tiled surface, two cones were positioned 32.1 m apart from each other. The participant was positioned next to one cone facing the second cone. The participant was instructed to propel themselves as rapidly as they could to the second cone, circle it, and return to the first, repeating the process as many times as they can within the trial’s 6-minute time frame. In scoring the PSQI, seven component scores are derived, each scored 0 (no difficulty) to 3 (severe difficulty). The component scores are summed to produce a global score (range 0 to 21). Higher scores indicate worse sleep quality.