Clinical trial NCT03330912: The Influence of Seat Height on Hemiplegic-pattern Propulsion of Manual Wheelchairs
Official title: The Influence of Seat Height on Hemiplegic-pattern Propulsion of Manual Wheelchairs
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Wheelchairs
Hemiplegia
Lead sponsor: Nova Scotia Health Authority
Sponsor class: OTHER
First posted: 2017-11-06
Enrollment: 50
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Intervention model description: Single subject - participants will be compared to themselves. STROBE guidelines will be followed.
Primary purpose: TREATMENT

Brief summary: This study evaluates the effect of seat height on hemiplegic-pattern wheelchair propulsion. Each subject will act as their own control and measures will be obtained in a one sixty minute session. Five seat heights relative to the subject's leg length will be measured in a random order to see the effect on forward and backwards wheelchair propulsion.

Detailed description: Many people who have suffered a stroke require a wheelchair for mobility. Hemiplegia is a common result of stroke.Many people with hemiplegia propel themselves using their sound-side arms and legs ("hemiplegic-pattern propulsion") in manual wheelchairs.Often people using this pattern are prescribed wheelchairs with a reduced seat height to facilitate foot propulsion. Despite the seeming obviousness of the need to lower the seat height for people who use foot propulsion,there is little available evidence to help establish optimal wheelchair seat height. The study objective is to test the hypothesis that there is an optimum wheelchair seat height (expressed as a percentage of the lower leg length) for hemiplegic-pattern wheelchair propulsion. The investigators expect that the optimum seat height will be lower than that usually used for wheelchairs that are hand-propelled.

A single-subject design with able-bodied participants will be used to investigate 5 randomized seat heights. The 5 seat heights will be set relative to the subjects leg length at a single 60 minute data collection session All measures will be obtained during one session. The optimal seat height will be chosen based on wheelchair propulsion speed, push frequency and effectiveness over 10m going forward on smooth surface, and 5m going backwards over a soft surface.

Eligibility criteria: Inclusion Criteria:

* willing to participate
* is right-hand dominant (to simplify wheelchair and laboratory set-up)
* has a subjective unshod height of ≤ 183 cm (6'0")
* is able to be comfortably seated in the manual wheelchair used for the study
* is 18 years of age or older, is alert and cooperative
* is competent to provide informed consent
* is able to communicate in English
* does not have an unstable medical condition

Exclusion Criteria:

-

Primary outcomes:
measure: speed (m/s)
timeFrame: same day measure obtained immediately after seat adjustment, approximately 10 minutes
measure: push frequency (cycles per second)
timeFrame: same day measure obtained immediately after seat adjustment, approximately 10 minutes
measure: Propulsion effectiveness
timeFrame: same day measure obtained immediately after seat adjustment, approximately 10 minutes
Secondary outcomes:
measure: forward propulsion wheelchair skills test score
timeFrame: same day measure obtained immediately after seat adjustment, approximately 10 minutes
measure: propulsion difficulty questionnaire
timeFrame: same day measure obtained immediately after seat adjustment, approximately 10 minutes
Other outcomes:
Locations:
city: Halifax
country: Canada
facility: Nova Scotia Rehabilitation and Arthritis Centre
state: Nova Scotia
Study officials:
affiliation: Nova Scotia Health Authority, Dalhousie University
name: Lee Kirby, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Heinrichs ND, Kirby RL, Smith C, Russell KFJ, Theriault CJ, Doucette SP. Effect of seat height on manual wheelchair foot propulsion, a repeated-measures crossover study: part 1 - wheeling forward on a smooth level surface. Disabil Rehabil Assist Technol. 2021 Nov;16(8):831-839. doi: 10.1080/17483107.2020.1741036. Epub 2020 Apr 2.
citation: Heinrichs ND, Kirby RL, Smith C, Russell KFJ, Theriault CJ, Doucette SP. Effect of seat height on manual wheelchair foot propulsion, a repeated-measures crossover study: part 2 - wheeling backward on a soft surface. Disabil Rehabil Assist Technol. 2022 Apr;17(3):325-330. doi: 10.1080/17483107.2020.1782490. Epub 2020 Jun 27.