title: Relationship between wheelchair propulsion and independent walking in hemiplegic stroke.
abstract: OBJECTIVE
  We studied the relationship between wheelchair propulsion and final walking ability in hemiplegic stroke patients who were unable to walk independently 3 or more weeks after stroke.
  
  
  METHODS
  Sixty hemiplegic stroke patients unable to walk independently 3 weeks or more after stroke were entered in a study comparing independent walking and wheelchair propulsion. Eight patients were lost to follow-up. Of the remaining 52 patients, 29 were entered 3 weeks and 23 were entered 4 to 10 weeks after stroke. Assessments were performed on admission and 4 and 14 weeks later.
  
  
  RESULTS
  Fifteen of the 17 patients able to propel a wheelchair through a simple course at 3 weeks after stroke learned to walk independently (chi 2 = 9.94, P = .01), but none of the 12 who failed learned to walk (chi 2 = 12, P = .001). At the final assessment, the positive association between wheelchair propulsion and walking had been lost: 21 of 21 walkers and 18 of 31 nonwalkers could propel a wheelchair (chi 2 = 0.23, P = NS). The negative association remained: 13 of 31 nonwalkers failed the wheelchair test, but 0 of 21 walkers failed (chi 2 = 13.0, P = .001). Visual field deficits were significantly more common in patients unable to walk or propel a wheelchair than in walkers (chi 2 = 6.66, P = .01). Laterality had no effect on outcome.
  
  
  CONCLUSIONS
  Ability to propel a wheelchair 3 weeks after stroke in hemiplegic patients unable to walk is the most accurate guide to walking potential that has been reported to date.
authors.affiliation: Greenwich District Hospital, Vanbrugh Hill, London, UK.
authors.forename: P W
authors.initials: PW
authors.lastname: Blower
authors.forename: L C
authors.initials: LC
authors.lastname: Carter
authors.forename: D A
authors.initials: DA
authors.lastname: Sulch
mesh_terms: D000368:Aged; D002561:Cerebrovascular Disorders / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013997:Time Factors; D016138:Walking; D014910:Wheelchairs / Q000706:statistics & numerical data*