New wheelie aid for wheelchairs: controlled trial of safety and efficacy.

OBJECTIVE: To test hypotheses that people learning to perform aided wheelies (AW) with a new self-deploying wheelie aid (WA) (1) are safer than those who use the conventional wheelie (CW), (2) are more successful at learning the skills, (3) learn more quickly, and (4) find such skills less difficult. DESIGN: Randomized, controlled study. SETTING: Wheelchair obstacle course. PARTICIPANTS: Forty-two subjects (12 wheelchair users, 30 able-bodied) randomly assigned to the CW (n = 23) or AW (n = 19) groups. INTERVENTIONS: We performed static tests on a WA-modified wheelchair occupied by a test dummy. We also attempted to teach each subject to perform a set of 14 wheelie-related skills. MAIN OUTCOME MEASURES: Visual analog scale (VAS) of safety, percentage of subjects able to learn the skills, the time required, and subjective difficulty scores (from 1 for "very easy" to 5 for "very difficult"). RESULTS: Up to 11.2 degrees of antitip-device stability was available without the WA extending beyond the rearmost aspect of the rear wheel in the resting position. For the CW and AW groups, the mean +/- standard deviation VAS safety scores were 43% +/- 27% and 98% +/- 2% (p <.0001), respectively; the overall success rates were 93% and 96% (p =.079), respectively; the mean times required to learn a skill (in 5-min increments) were 1.56 +/- 1.08 minutes and.72 +/-.35 minutes (p =.002), respectively; and the mean difficulty scores were 2.94 +/-.38 and 2.23 +/-.34 (p <.0001), respectively. CONCLUSIONS: The new WA provides stability and wheelie-like function without interfering with maneuverability. Although both groups were equally successful, learning to perform AWs is safer, faster, and less difficult than learning CWs.

Spotter strap for the prevention of wheelchair tipping.

Injuries caused by wheelchair rear-tipping accidents are common. This article reports on the safety and effectiveness of a spotter strap that attaches to the cross-brace or frame below the center of gravity of an occupied wheelchair. We videotaped five therapists spotting 89 wheelchair users while the users each performed six tasks that were designed to induce rear instability. We induced 16 episodes of complete rear tipping. In all cases, the spotter strap allowed the spotter to stay out of the way during the task, but step in easily when necessary to prevent the wheelchair user from being injured. In one instance, the spotter needed assistance lifting a heavy subject to the upright position after catching the subject with the strap. In summary, the spotter strap is a safe and effective device. We recommend its use when there is a high risk of a rear-tipping accident.

Wheelchair propulsion: descriptive comparison of hemiplegic and two-hand patterns during selected activities.

Most manual wheelchair users with hemiplegia use both the unaffected arm and leg to propel their wheelchairs. The objective of this study was to compare the wheelchair propulsion of subjects using the hemiplegic pattern (one arm and one leg) with subjects using two hands. In a case-controlled study in a kinesiologic laboratory, nine wheelchair users who used the hemiplegic pattern were compared with nine matched controls who used the two-handed pattern. Participants were tested for propelling and stopping the wheelchair, forward and backward, on a level surface and on a 5 degree incline. Video recording was used to assess deviation from the midline, foot slippage, the number of propulsive cycles, and the propelling velocity. Also, on the 5 degree incline, we noted the need for support when unlocking the wheel locks, instances of grabbing the side rail, or rollback between propulsions. The participants using the hemiplegic pattern when propelling up the incline deviated more to the hemiparetic side (P < 0.05), used more propulsive cycles per unit of distance (P < 0.01), were slower (P < 0.001), and used the side rail more often (P < 0.05). When propelling forward on level ground, the participants using the hemiplegic pattern were slower (P < 0.005). When stopping after moving backward down the incline, they were more likely to deviate to the unaffected side (P < 0.01). In conclusion, wheelchair users who use the hemiplegic pattern experience more difficulties than those using two hands, some of which may be amenable to improvements in wheelchair prescription and training.