Hemiplegia, Wheelchairs
Conditions
Brief summary
This study evaluates the effect of seat height on hemiplegic-pattern wheelchair propulsion. Each subject will act as their own control and measures will be obtained in a one sixty minute session. Five seat heights relative to the subject's leg length will be measured in a random order to see the effect on forward and backwards wheelchair propulsion.
Detailed description
Many people who have suffered a stroke require a wheelchair for mobility. Hemiplegia is a common result of stroke.Many people with hemiplegia propel themselves using their sound-side arms and legs (hemiplegic-pattern propulsion) in manual wheelchairs.Often people using this pattern are prescribed wheelchairs with a reduced seat height to facilitate foot propulsion. Despite the seeming obviousness of the need to lower the seat height for people who use foot propulsion,there is little available evidence to help establish optimal wheelchair seat height. The study objective is to test the hypothesis that there is an optimum wheelchair seat height (expressed as a percentage of the lower leg length) for hemiplegic-pattern wheelchair propulsion. The investigators expect that the optimum seat height will be lower than that usually used for wheelchairs that are hand-propelled. A single-subject design with able-bodied participants will be used to investigate 5 randomized seat heights. The 5 seat heights will be set relative to the subjects leg length at a single 60 minute data collection session All measures will be obtained during one session. The optimal seat height will be chosen based on wheelchair propulsion speed, push frequency and effectiveness over 10m going forward on smooth surface, and 5m going backwards over a soft surface.
Interventions
DEVICENeutral seat height
Seat height set relative to participant's leg length with neutral set at the measured lower leg length
DEVICEVery low seat height
Seat height set relative to participant's leg length, 2 below the measured lower leg length
DEVICELow seat height
Seat height set relative to participant's leg length, 1 below the measured lower leg length
DEVICEVery high seat height
Seat height set relative to participant's leg length, 2 above the measured lower leg length
DEVICEHigh seat height
Seat height set relative to participant's leg length, 1 above the measured lower leg length
Sponsors
Lee Kirby
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Single subject - participants will be compared to themselves. STROBE guidelines will be followed.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* willing to participate * is right-hand dominant (to simplify wheelchair and laboratory set-up) * has a subjective unshod height of ≤ 183 cm (6'0) * is able to be comfortably seated in the manual wheelchair used for the study * is 18 years of age or older, is alert and cooperative * is competent to provide informed consent * is able to communicate in English * does not have an unstable medical condition
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| speed (m/s) | same day measure obtained immediately after seat adjustment, approximately 10 minutes | wheelchair propulsion speed over 10 m forward and 5 m backward |
| push frequency (cycles per second) | same day measure obtained immediately after seat adjustment, approximately 10 minutes | number of foot cycles completed over the 10 m forward and 5 m backward |
| Propulsion effectiveness | same day measure obtained immediately after seat adjustment, approximately 10 minutes | distance travelled per foot propulsion cycle |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| forward propulsion wheelchair skills test score | same day measure obtained immediately after seat adjustment, approximately 10 minutes | fail, pass with difficulty or pass for wheeling forward 10 m |
| propulsion difficulty questionnaire | same day measure obtained immediately after seat adjustment, approximately 10 minutes | Investigator developed questionnaire asking how difficult it was to perform the propulsion test. The participant will self-report his/her level of difficulty for this skill using a five-point Likert scale (1 =very easy, 2=somewhat easy, 3=neither easy nor difficult, 4= somewhat difficult and 5=very difficult). A single number will be reported. |
Countries
Canada
Outcome results
None listed