Effect of a pushrim-activated power-assist wheelchair on the functional capabilities of persons with tetraplegia.
OBJECTIVE
To test the differences between a pushrim-activated power-assisted wheelchair (PAPAW) and a traditional manual wheelchair while performing common driving activities and to assess their relative merits for people with tetraplegia.


METHODS
Repeated measures.


METHODS
An activities of daily living (ADL) laboratory within a rehabilitation research center.


METHODS
Fifteen full-time manual wheelchair users with tetraplegia due to a spinal cord injury.


METHODS
Participants propelled both their own manual wheelchairs and a PAPAW 3 times over an ADL course. The order in which the 2 different wheelchairs were presented to the participants was randomized.


METHODS
Each participant's heart rate was monitored throughout testing by a digital, wireless heart-rate monitor. Time to complete the course was recorded, and participants were surveyed with a visual analog scale after the first, third, fourth, and sixth trials to determine the ease of completing each obstacle and their ergonomic preferences between the 2 wheelchairs. Participants also were observed throughout the trials to determine how much assistance they needed to complete each obstacle course.


RESULTS
After using a Bonferroni adjustment, 4 obstacles (carpet, dimple strips, up a ramp, up a curb cut) were rated as being significantly easier ( P <.001) to complete when using the PAPAW. Participants also showed a significant decrease in mean heart rate throughout all 3 trials ( P =.015, P =.001, P =.003, respectively) when using a PAPAW. The amount of assistance needed by participants, the responses to ergonomic questions, and the overall time to complete the ADL course did not differ significantly between the 2 wheelchairs.


CONCLUSIONS
For subjects with tetraplegia, PAPAWs have the potential to improve functional capabilities during certain ADLs, especially when propelling up ramps, over uneven surfaces, and over thick carpet.
Algood
S David
SD
Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
Cooper
Rory A
RA
Fitzgerald
Shirley G
SG
Cooper
Rosemarie
R
Boninger
Michael L
ML
D000203:Activities of Daily Living; D000328:Adult; D004867:Equipment Design; D006804:Ergonomics; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011782:Quadriplegia / Q000209:etiology / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000150:complications; D014910:Wheelchairs