Wheelchair-skill performance: controlled comparison between people with hemiplegia and able-bodied people simulating hemiplegia.

OBJECTIVE To test the hypothesis that able-bodied people simulating hemiplegia (using the hemiplegic-propulsion pattern [1 arm and 1 leg]) have as much difficulty performing wheelchair skills as people with hemiplegia. DESIGN Single-blind, controlled comparison of 2 groups. SETTING Kinesiologic laboratory in a rehabilitation center. PARTICIPANTS Twenty wheelchair users with hemiplegia (HP group) (median age, 68y; 80% men) and 20 able-bodied participants (AB group) (median age, 67y; 75% men). INTERVENTIONS The participants in the AB group simulated hemiplegia and received a brief period of wheelchair skills training. Participants in both groups were asked to attempt the 50 skills of the Wheelchair Skills Test, version 2.4 (WST 2.4). MAIN OUTCOME MEASURES Total and subtotal percentage scores on the WST 2.4 and success rates for the 50 individual skills. RESULTS The mean percentage WST scores for the AB group were significantly greater than those for the HP group for the total WST scores ( P <.001), the indoor skill level ( P <.001), and the community skill level ( P <.001), but the advanced skill level scores were 0% for both groups. On the individual skills, the AB group had success rates at least 25% higher than the HP group for 13 (26%) of the skills. Both groups were generally successful (>/=75% success rate) on 21 skills (42%). Both groups experienced difficulties (</=50% success rate) on 13 skills (26%), notably those in which there was high rolling resistance (eg, incline ascent) or high balance demands (the wheelie skills). CONCLUSIONS Both people with hemiplegia and able-bodied people who are simulating hemiplegia experience similar difficulties when performing some wheelchair skills. This suggests that there are difficulties inherent in these tasks, a finding that holds promise for solutions based on new techniques and technologies.