Assessment of the Effectiveness and Safety of Wheelchair Use Training for Patients with Hemiparesis

Abstract

INTRODUCTION. The rationale of the research is defined by the large number of patients with hemiparesis, unable to restore an upright posture and in need of training to use a wheelchair. AIM. To present the methodology of wheelchair training of patients with hemiparesis. MATERIALS AND METHODS. We observed 30 patients with severe hemiparesis during wheelchair training. Examination included assessment of clinical, neurological, and mental status (MMSE — Mini-Mental State Examination), testing of limb muscle strength according to Lovett’s scale modified by L.D. Potekhin, level of sitting function compensation assessment, wheelchair skills (Wheelchair Skills Test). Each patient attended 10 wheelchair training sessions and related physical therapy (PT) sessions, with PT classes preceding the wheelchair training sessions and practicing the wheelchair-using movements required in the wheelchair training sessions. Patients controlled the wheelchair using only healthy limbs. RESULTS. At the moment of admission, 14 patients were not able to use wheelchair independently; 16 patients were able to use wheelchair to varying degrees. As a result of the sessions, the muscle strength of healthy limbs increased; statistically significant improvement in sitting and wheelchair skills was noted. None of the patients who scored 10 for MMSE test improved their wheelchair skills. CONCLUSION. Persons with severe hemiparesis learn to use the wheelchair with the help of healthy limbs. Physical therapy sessions precede wheelchair training and form the movements necessary for learning to use the wheelchair.