The Influence of Seat Height on Hemiplegic-pattern Propulsion of Manual Wheelchairs

Not Applicable

Completed

• Conditions: Wheelchairs; Hemiplegia
• Interventions: Device: Neutral seat height; Device: Very low seat height; Device: Low seat height; Device: Very high seat height; Device: High seat height

• Registration Number: NCT03330912
• Lead Sponsor: Lee Kirby

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.

Study Timeline

• Study First Submitted: 2017-10-30
• Study First Submitted QC: 2017-10-31
• Study First Posted: 2017-11-06
• Study Start: 2018-05-01
• Primary Completion: 2019-09-01
• Study Completion: 2019-09-01
• Status Verified: 2020-09
• Last Update Submitted: 2020-09-09
• Last Update Posted: 2020-09-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Seat Height Intervention	Neutral seat height	Randomly assigned 5 wheelchair seat heights ranging from very low (2" below) to very high (2" above) the lower leg length of the participant.
Seat Height Intervention	Low seat height	Randomly assigned 5 wheelchair seat heights ranging from very low (2" below) to very high (2" above) the lower leg length of the participant.
Seat Height Intervention	Very low seat height	Randomly assigned 5 wheelchair seat heights ranging from very low (2" below) to very high (2" above) the lower leg length of the participant.
Seat Height Intervention	Very high seat height	Randomly assigned 5 wheelchair seat heights ranging from very low (2" below) to very high (2" above) the lower leg length of the participant.
Seat Height Intervention	High seat height	Randomly assigned 5 wheelchair seat heights ranging from very low (2" below) to very high (2" above) the lower leg length of the participant.

Primary Outcome Measures

Name	Time	Method
Propulsion effectiveness	same day measure obtained immediately after seat adjustment, approximately 10 minutes	distance travelled per foot propulsion cycle
speed (m/s)	same day measure obtained immediately after seat adjustment, approximately 10 minutes	wheelchair propulsion speed over 10 m forward and 5 m backward
push frequency (cycles per second)	same day measure obtained immediately after seat adjustment, approximately 10 minutes	number of foot cycles completed over the 10 m forward and 5 m backward

Secondary Outcome Measures

Name	Time	Method
forward propulsion wheelchair skills test score	same day measure obtained immediately after seat adjustment, approximately 10 minutes	fail, pass with difficulty or pass for wheeling forward 10 m
propulsion difficulty questionnaire	same day measure obtained immediately after seat adjustment, approximately 10 minutes	Investigator developed questionnaire asking how difficult it was to perform the propulsion test. The participant will self-report his/her level of difficulty for this skill using a five-point Likert scale (1 =very easy, 2=somewhat easy, 3=neither easy nor difficult, 4= somewhat difficult and 5=very difficult). A single number will be reported.

Trial Locations

Locations (1)

Nova Scotia Rehabilitation and Arthritis Centre; 🇨🇦 Halifax, Nova Scotia, Canada