Measures of energy expenditure and comfort in an ESP wheelchair: a controlled trial using hemiplegic users'

Aim. The aim of this pilot study using hemiplegic subjects was to measure energy expenditure, hand position and ride comfort, in a standard dual handrim Sunrise Breezy wheelchair compared to one modified with a novel ergonomic self-propelled steering (ESP) mechanism kit. A previous study by Mandy et al. (Disabil Rehabil Assist Technol 2007;2:255–260) reported that the attachment of the ESP kit to a standard Sunrise Breezy wheelchair provided a more ergonomically efficient mechanism for wheelchair steering and propulsion for non-disabled individuals. Methods. Thirteen hemiplegic stroke users participated in a repeated measures trial by driving two manual wheelchairs – a standard manual dual handrim wheelchair and one fitted with the ESP steering conversion kit. Wheelchairs were randomly assigned, to participants who drove each wheelchair around a designated circuit. Oxygen consumption, carbon dioxide and heart rate were measured as indicators of ergonomic efficiency using a Cosmed analyser. Comfort for each wheelchair was measured using a validated questionnaire. Results. Oxygen consumption (O2mls/min) and exhaled carbon dioxide (CO2mls/min) were significantly lower in the modified wheelchair (p < 0.004 and p < 0.04, respectively). Time taken to complete the course was significantly faster in the ESP (p < 0.001). There was no significant difference in heart rate readings between the wheelchairs. All comfort ratings were reported to be significantly greater in the ESP (p < 0.01). Conclusions. The ESP conversion kit transforms a standard Sunrise Breezy wheelchair into one that is ergonomically more efficient and comfortable for hemiplegic subjects.