Bimanual wheelchair propulsion by people with severe hemiparesis after stroke.

Conclusions: Individuals with severe arm impairment in the chronic stage of stroke retain sufficient strength and coordination with their paretic arm to manoeuvre 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. Implications for rehabilitation Severe arm impairment arising after stroke does not generally eliminate the motor dexterity needed to bimanually propel a manual wheelchair, provided that the wheelchair is modified to remove the requirement to grasp and release the push rim. Such exercise appears a good candidate to facilitate rehabilitation outcomes because it depends on alternating muscle activity and improving elbow extension. Such wheelchair propulsion involves largely normal biomechanics; shoulder hiking and leaning are absent and trunk inclination is rare. PMID: 31248296 [PubMed - as supplied by publisher]
Source: Disability and Rehabilitation. Assistive Technology. - Category: Rehabilitation Authors: Tags: Disabil Rehabil Assist Technol Source Type: research