A novel design and clinical evaluation of a wheelchair for stroke patients

Hemiplegic stroke patients are physically able to use only one arm and leg, those on the unaffected side, to propel and steer a manual wheelchair; therefore, it is difficult for them to use current manual wheelchairs. Although there have been a number of outstanding studies on wheelchair propulsion, very few have dealt with the wheelchair propulsion problems for stroke patients, whose propulsion styles are greatly different from users with healthy upper limbs. The purpose of this study was to develop a novel wheelchair for stroke patients based on their needs. A planar four-bar chain mechanism was introduced to develop the new wheelchair, and a clinical evaluation in a rehabilitation center was also done to evaluate the chair's usability. The prototype we developed allows stroke patients to use their legs and arms together to propel the wheelchair, and permits them to steer the wheelchair safely and efficiently. Eleven stroke patients with right hemiplegia were recruited to clinically evaluate the newly designed prototype, the unilaterally propelled wheelchair (UPW), in a comparison with a commercial two-handrim propelled wheelchair (TPW). The results revealed that the velocity, deviation frequency, and deviation period of the UPW were superior to those of the TPW. We concluded that it is easier, safer, and more efficient for hemiplegic stroke patients to use the UPW than the TPW. Relevance to industry The manual wheelchair has many demonstrable benefits for users who have mobility problems and sufficient upper-limb strength to propel one. However, it can be difficult for stroke patients to propel current manual wheelchairs. This study offers an innovative wheelchair, designed with the needs of hemiplegic stroke patients in mind, that offers improved efficiency and safety, thereby promoting independent living. (C) 2007 Published by Elsevier B.V.