Usefulness of a Leg-pedaled Wheelchair for Hemiplegic Patients

Abstract

Background: Although hemiplegic patients often use an ordinary wheelchair (OW), by propelling the hand rim with the unaffected hand and pushing the ground backward using the unaffected leg, it is a hard task for them over any great distance. If patients could drive a leg-pedaled wheelchair (LW) using both legs, it would be less hard on them. Aims: This study was performed to determine whether or not hemiplegic patients can pedal the LW, and whether pedaling the LW is easier and faster than using an ordinary wheelchair. Methods: The subjects were 5 poststroke hemiplegic patients whose severity of lower extremity paralysis was III or IV on Brunnstrom's Motor Recovery Stage. The subjects practiced propelling a standard wheelchair for the OW trials and pedaling an EZchair^® for the LW trials. After the subjects became skilled in driving both wheelchairs, they were asked to propel the OW and to pedal the LW on a slalom course to evaluate controllability, and on a rectangular course to evaluate wheelchair speed. Physiological cost index (PCI) was obtained for evaluation of driving efficiency. Results: All subjects could pedal the LW without any trouble. The wheelchair speed of the LW on both courses was faster than the OW. The PCI when pedaling the LW on the rectangular course was lower than when propelling the OW. However, the LW was less controllable in braking. Conclusion: Although the LW used still requires some minor modifications, we believe that a LW is suitable for hemiplegic patients who want to travel a long distance in their wheelchairs.