Hiroyuki Miyasaka, OTR, PhD, Yuki Nakagawa, OTR, Hideto Okazaki, MD, PhD, Shigeru Sonoda, MD, PhD
Jpn J Compr Rehabil Sci 14: 54-59, 2023
Objectives: This study investigated the influence of
different sitting postures on wheelchair propulsion
ability.
Methods: The subjects were stroke patients who
scored at least 2 points on the Stroke Impairment
Assessment Set for abdominal muscle strength and
trunk verticality and 3 points for non-paralytic side
lower-limb muscle strength. Moreover, the patients
were divided by their everyday wheelchair propulsion
posture: Lean on Back Support (LBS); n=8), those
who leaned their back against the back support; and
non-LBS (n=11), those who moved their back away
from the back support. For the wheelchair propulsion
method, straight one-hand, one-leg propulsion was
used on the non-paralyzed side for 10 m, followed by
turning around a target 3 m ahead on each of the
paralyzed and non-paralyzed sides. We then compared
the propulsion times, number of propulsions, and
difference in length from the front end of the patella on
the non-paralyzed side to the front end of the seat
surface (buttock sliding distance) between the groups.
Results: The buttock sliding distance was significantly
shorter in the non-LBS group than in the LBS group in
the paralyzed and non-paralyzed side turning tasks (p<0.05). Propulsion times, number of propulsions, and
grip strength did not differ significantly between the
groups.
Conclusion: Even in patients with good trunk function,
propulsion while leaning against the back support can
easily result in anterior buttock sliding, leading to a
secondary risk of injury. These results suggest that it is
necessary to provide guidance on the propulsion posture
and seating to hold the trunk vertically to minimize
anterior sliding during propulsion.
Key words: stroke, wheelchair, driving ability, anterior sliding