Disadvantages of the early use of wheelchairs in the treatment of hemiplegia

Ashburn, Ann; Lynch, Mary

doi:10.1177/026921558800200411

Cited by 19 publications

(10 citation statements)

References 5 publications

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“…There is much controversy in this country about the use of self-propelling wheelchairs with early stroke patients. Blowers (1988) and Ashburn and Lynch (1988) documented the advantages and disadvantages of the early use of wheelchairs in the treatment of stroke patients respectively. Blowers (1988) described the advantages of using wheelchairs but explained that they should be used with hospitalised patients suffering from moderate or severe strokes only.…”

Section: Randomised Controlled Trial Studies Following the Transfer Omentioning

confidence: 99%

A comparison of two approaches in the treatment of perceptual problems after stroke

Edmans¹,

Webster

Lincoln

2000

Clin Rehabil

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Section: Randomised Controlled Trial Studies Following the Transfer Omentioning

confidence: 99%

A comparison of two approaches in the treatment of perceptual problems after stroke

Edmans¹,

Webster

Lincoln

2000

Clin Rehabil

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“…[16][17][18] They are taught to use their less-impaired arm and leg to propel their wheelchair, a compensatory strategy that may contribute to asymmetric tone. 19,20 Alternatively, they may resort to a powered wheelchair that does not provide for upper extremity training in addition to being expensive and heavy. Either way, failing to train the upper extremity can lead to a cycle of learned disuse and decreasing functional ability.…”

Section: Introductionmentioning

confidence: 99%

Bimanual wheelchair propulsion by people with severe hemiparesis after stroke

Smith

Bueno²,

Zondervan

et al. 2019

Disability and Rehabilitation: Assistive Technology

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250 word max) Aim: Individuals who require manual wheelchairs after stroke are typically taught to ambulate with compensatory propulsion (i.e. using their nonparetic arm and foot), risking disuse of the paretic arm. We investigated whether stroke survivors can instead ambulate in a bimanual, leverdriven wheelchair that requires the paretic arm to contribute half the propulsive input.Methods: Seventeen individuals with chronic stroke and severe hemiparesis (upper extremity Fugl-Meyer scores between 10 and 24) participated across two experiments. In the first experiment participants (n=12) ambulated in straight paths. In the second experiment participants (n=12) also performed turns, using an improved version of the wheelchair that incorporated handbrakes.Twelve unimpaired controls also completed the second experiment. Motion capture and EMG were used to compare biomechanics between groups.Results: Altogether, 15 of 17 participants with stroke could ambulate 30 m in straight paths, and 9 of 12 could turn 1800° entirely under the power of their paretic arm. Participants with stroke exhibited largely healthy biomechanics, with minimal shoulder hiking/leaning or trunk inclination.Their arm muscle EMG patterns were similar to those used by unimpaired participants, excepting delayed elbow extensor activation.Conclusions: Individuals with severe arm impairment in the chronic stage of stroke retain sufficient strength and coordination with their paretic arm to maneuver bimanual, lever-driven wheelchairs. We suggest bimanual, lever driven propulsion should be explored in stroke rehabilitation practice as an alternative to compensatory wheelchair propulsion, as it has the potential to exercise healthy movement synergies, which may in turn help drive use-dependent motor recovery.

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“…In addition the unwanted movements may also interfere with activities of daily living as well as being caused by them. During stroke rehabilitation there is often a conflict between the need to mobilize patients (5) and to prevent them from participating in activities that promote AR (6,7). The presence of AR during stroke recovery is suggested to hinder development of normal movement (8) and therefore considerable rehabilitation resources may be directed at treating these abnormal movements.…”

Section: Introductionmentioning

confidence: 99%