Understanding Urban Mobility Among Wheelchair Users: The Intersection of Physical Impairment, Wheelchair Mobility Proficiency, and Self-Efficacy in Wheeled Mobility-A Scoping Review.

Background/Objectives: Urban accessibility is a key determinant of participation for manual wheelchair users, yet accessibility experiences vary according to physical impairment, self-efficacy in wheeled mobility, and wheelchair mobility proficiency. This scoping review examined urban accessibility challenges in relation to these three dimensions. Methods: Following PRISMA-ScR guidelines, eight databases were searched for English-language peer-reviewed studies published from January 2015 to May 2025. Eligible studies addressed outdoor or urban mobility challenges among manual wheelchair users in relation to at least one dimension. Two reviewers independently screened records, assessed full texts, and extracted data using a standardized form. Findings were synthesized within an International Classification of Functioning, Disability and Health-informed framework. Fourteen studies were included. Results: The evidence base was methodologically diverse and fragmented; no study examined all three dimensions simultaneously, and wheelchair mobility proficiency received the least attention. Greater physical impairment was associated with more perceived barriers and higher effort. Self-efficacy influenced avoidance of or engagement in mobility tasks beyond physical functioning. Wheelchair mobility proficiency, supported by training, experience, and wheelchair fit, was associated with managing ramps, uneven surfaces, and other environmental demands, but was rarely assessed using standardized performance measures. Conclusions: Urban accessibility reflects interactions among physical functioning, self-efficacy, wheelchair mobility proficiency, assistive-device characteristics, and environmental conditions. Accordingly, urban mobility should be understood as a person-wheelchair-environment interaction rather than solely as an interaction between the individual and the built environment. Integrative studies using standardized measures and more systematic reporting of wheelchair fit and configuration are needed to inform impairment-inclusive urban planning, rehabilitation, and policy.