title: The natural-fit handrim: factors related to improvement in symptoms and function in wheelchair users.
abstract: OBJECTIVE
  People with spinal cord injury (SCI) may spend several decades using a wheelchair as their primary means of mobility. Secondary injury and a decline in independence over time are common with manual wheelchair users who, in turn, may require increased assistance as time passes. The Natural-Fit contoured handrim has been shown to improve symptoms and function in people with SCI who use manual wheelchairs and who have experienced upper extremity pain. The objective of this study was to determine the factors associated with improved symptoms and functions.
  
  
  METHODS
  87 people who purchased the ergonomic wheelchair handrims. Participants were predominately men, with a median age of 51 to 55 years, median level of injury T10 to T12, median time in a wheelchair of 15 years, and they had used the contoured rims for 1 to 2 years.
  
  
  METHODS
  This was a mail survey of 217 people who purchased the rims. The survey was mailed out from the manufacturer and was anonymously returned to the physical therapy department of a university. A $10 incentive was offered for returning the survey.
  
  
  RESULTS
  The majority of participants reported improvements in upper extremity symptoms, ease of wheelchair propulsion, and functional status. Longer use of the rims was associated with reported improvement in ease of wheelchair propulsion and reduction in pain in hands and wrists.
  
  
  CONCLUSIONS
  If a simple modification of the wheelchair can help bring about significant changes in the users' symptoms and function, this modification should be incorporated by people who use manual wheelchairs before decline in function begins. Proactive intervention may alleviate symptoms, help the person maintain maximal independence, and prolong the length of time the individual remains independent.
authors.affiliation: Department of Orthopedics, University of New Mexico, Albuquerque, NM 87131, USA. kdieruf@salud.unm.edu
authors.forename: Kathy
authors.initials: K
authors.lastname: Dieruf
authors.forename: Lynette
authors.initials: L
authors.lastname: Ewer
authors.forename: David
authors.initials: D
authors.lastname: Boninger
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D004867:Equipment Design; D006804:Ergonomics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012044:Regression Analysis; D013119:Spinal Cord Injuries / Q000473:pathology / Q000503:physiopathology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology; D014910:Wheelchairs / Q000706:statistics & numerical data