Comparison of activities of daily living (ADLs) in two different one arm drive wheelchairs: a study of individuals/participants with hemiplegia.

AIMS: This pilot study measured activities of daily living performance in individuals/participants with hemiplegia propelling both a standard dual handrim Action 3 wheelchair and a standard Action 3 wheelchair with a Neater Uni-Wheelchair kit attachment. The kit consists of a steerable front. RESEARCH QUESTIONS: Does the use of the NUW affect the performance quality of activities of daily living in individuals/participants with hemiplegia. Is there a difference in the motor and process skills during activities of daily living performance, and in the time taken to complete the activities. METHODS: Four individuals/participants with hemiplegia were used in a cross over, repeated measures trial. Assessment of Motor and Process Skills of users undertaking making a bed and laying a table "Swedish style", tasks were measured and time taken to complete each task were recorded. RESULTS: Bed making completion time was quicker in the Neater Uni-wheelchair (p < 0.03). Motor skills were significantly higher than the process ability skills (p < 0.05). CONCLUSION: Activities of daily living tasks in the Neater Uni-wheelchair were completed more efficiently with no loss in quality of motor and process skills performance. This suggests that the Neater Uni-wheelchair is a viable alternative to current one arm drive provision. Implications for Rehabilitation Inappropriate wheelchair provision can result in capacity limitation and poorer quality of ADL motor skill as well-lowered process performance skill. AMPS can help to explain motor and process skill differences in complex activities.

Measurement of hand/handrim grip forces in two different one arm drive wheelchairs.

PURPOSE: The aim of this study was to explore the total and regional grip forces in the hand when propelling two different manual one arm drive wheelchairs: the Neater Uni-wheelchair (NUW) and a foot steered Action3 wheelchair. METHODS: 17 nondisabled users were randomly assigned to each wheelchair to drive around an indoor obstacle course. The Grip, a multiple sensor system taking continuous measurement of handgrip force, was attached to the propelling hand. Total grip force in each region of the hand and total grip force across the whole hand were calculated per user per wheelchair. RESULTS: The Action3 with foot steering only generated significantly greater total grip force in straight running compared to the NUW and also in the fingers and thumb in straight running. CONCLUSIONS: The results suggest that the Action3 with foot steering generated greater grip forces which may infer a greater potential for repetitive strain injury in the upper limb. Further work is required to explore whether the difference in grip force is of clinical significance in a disabled population.

A comparison of vertical reaction forces during propulsion of three different one-arm drive wheelchairs by hemiplegic users.

PURPOSE: The aim of this pilot study was to compare the vertical reaction forces (N) generated in three different Action 3 manual one-arm drive wheelchairs: dual handrim, a lever drive and a Neater Uni-wheelchair (NUW). A CONFORmat® Pressure measurement mat, placed on top of the users' prescribed cushion, measured vertical force at the buttock/seat interface on both hemiplegic and non-hemiplegic sides in each wheelchair. METHODS: Fifteen hemiplegic users were randomly assigned each wheelchair to drive around an indoor obstacle course. During propulsion of a multiple sensor, continuous measurement of force was recorded. Time taken to complete the circuit was recorded. Mean force and confidence intervals for each buttock were calculated per user per wheelchair. RESULTS: The dual handrim produced the highest vertical force during propulsion under the right buttock (x= 484.43; SD = 55.4; p < 0.001) and the lever drive produced the least force (x= 368.05; SD = 53.55; p < 0.01). The NUW completed the course quickest (p < 0.01). CONCLUSIONS: The dual-handrim wheelchair requires the greatest vertical force during propulsion. Since increases in this seat vertical reaction force may be related to the propulsive force. Further investigation is indicated as this may be a significant factor for clinicians when prescribing one-arm drive wheelchairs. Implications for Rehabilitation Review of clinical reasoning in prescribing wheelchairs. Addition of the Neater Uni-wheelchair to wheelchair services prescribing lists.