TY - JOUR
T1 - A systematic review on the pros and cons of using a pushrim-activated power-assisted wheelchair
AU - Kloosterman, Marieke
AU - Snoek, G.J.
AU - van der Woude, L.H.V.
AU - Buurke, Jaap
AU - Rietman, Johan Swanik
PY - 2013
Y1 - 2013
N2 - Objective: To determine the (dis)advantages of transition to a power-assisted wheelchair, and derive the clinical implications for its use or prescription.
Data sources: Relevant articles published prior to May 2012 were identified using PubMed, Cochrane Library, REHABDATA, CIRRIE and CINAHL databases.
Review methods: Clinical or (randomized) controlled trials, published in a peer-reviewed journal, comparing power-assisted wheelchair use and hand-rim or powered wheelchair use were eligible. Data quality and validity were assessed by two reviewers independently using the Checklist for Measuring Quality developed by Downs and Black.
Results: A systematic search yielded 15 cross-over trails with repeated measurement design and one qualitative interview. Methodological quality scored between 9 and 15 points out of the maximum score of 32. Ten studies measuring body function and structure reported reduced strain on the arm and cardiovascular system during power-assisted propulsion compared to hand-rim propulsion. Twelve studies measuring activities and social participation reported precision tasks easier to perform with a hand-rim wheelchair and tasks which require more torque were easier with a power-assisted wheelchair. Social participation was not altered significantly by the use of a hand-rim, powered or power-assisted wheelchair.
Conclusion: Power-assisted propulsion might be beneficial for subjects in whom independent hand-rim wheelchair propulsion is endangered by arm injury, insufficient arm strength or low cardiopulmonary reserves. Also, subjects who have difficulty propelling a wheelchair in a challenging environment can benefit from power-assisted wheelchair use. Caution is warranted for the additional width and weight in relation to the usual mode of transportation and access to the home environment.
AB - Objective: To determine the (dis)advantages of transition to a power-assisted wheelchair, and derive the clinical implications for its use or prescription.
Data sources: Relevant articles published prior to May 2012 were identified using PubMed, Cochrane Library, REHABDATA, CIRRIE and CINAHL databases.
Review methods: Clinical or (randomized) controlled trials, published in a peer-reviewed journal, comparing power-assisted wheelchair use and hand-rim or powered wheelchair use were eligible. Data quality and validity were assessed by two reviewers independently using the Checklist for Measuring Quality developed by Downs and Black.
Results: A systematic search yielded 15 cross-over trails with repeated measurement design and one qualitative interview. Methodological quality scored between 9 and 15 points out of the maximum score of 32. Ten studies measuring body function and structure reported reduced strain on the arm and cardiovascular system during power-assisted propulsion compared to hand-rim propulsion. Twelve studies measuring activities and social participation reported precision tasks easier to perform with a hand-rim wheelchair and tasks which require more torque were easier with a power-assisted wheelchair. Social participation was not altered significantly by the use of a hand-rim, powered or power-assisted wheelchair.
Conclusion: Power-assisted propulsion might be beneficial for subjects in whom independent hand-rim wheelchair propulsion is endangered by arm injury, insufficient arm strength or low cardiopulmonary reserves. Also, subjects who have difficulty propelling a wheelchair in a challenging environment can benefit from power-assisted wheelchair use. Caution is warranted for the additional width and weight in relation to the usual mode of transportation and access to the home environment.
KW - METIS-291987
KW - IR-85319
U2 - 10.1177/0269215512456387
DO - 10.1177/0269215512456387
M3 - Article
SN - 0269-2155
VL - 27
SP - 299
EP - 313
JO - Clinical rehabilitation
JF - Clinical rehabilitation
IS - 4
ER -