Article

OBJECTIVE: To test the hypotheses that people with hemiplegia using arms and legs
to propel their wheelchairs perform better backward than forward and prefer the
backward direction. DESIGN: Within-participant cross-sectional design.
PARTICIPANTS: Manual wheelchair users (N=18) with hemiplegia caused by stroke,
a sample of convenience. SETTING: Rehabilitation center. INTERVENTION: Participants
each performed 9 skills from the Wheelchair Skills Test (WST 4.1)-4 low-rolling-resistance skills (rolls 10m, turns 90 degrees while moving, rolls 2m
across 5 degrees side slope, descends 5cm level change) and 5 high-rolling-resistance skills (ascends 5 degrees incline, rolls 2m on soft
surface, gets over 15-cm pothole, gets over 2-cm threshold, ascends 5cm level
change)-in both the forward and backward directions, in random order. MAIN
OUTCOME MEASURES: Total percentage capacity scores from the modified WST 4.1,
success rates for individual skills, and responses from an orally administered
questionnaire regarding direction preferences. RESULTS: The mean +/- SD total WST
4.1 capacity scores were 53%+/-26% in the forward direction and 76%+/-30% in the
backward direction (P<.001). For the 4 low-rolling-resistance skills, there were
no clinically significant differences (>/=20%) between forward and backward
success rates. For the 5 high-rolling-resistance skills, the success rates were
33% to 50% higher in the backward direction. Participants preferred the forward
direction for low-rolling-resistance skills and the backward direction for
high-rolling-resistance skills. CONCLUSIONS: Wheelchair skills that involve high
rolling resistance are performed more successfully in the backward than the
forward direction, and participants prefer the backward direction for such
skills. These findings have implications for wheelchair selection and skills
training.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS