Purpose
We aimed to evaluate the relationship between the daily wheelchair
self-propulsion distance and functional recovery in subacute stroke
survivors.
Methods
Seventy-four patients with stroke were prospectively recruited from
four convalescent rehabilitation hospitals. All participants were unable
to walk independently and required manual wheelchairs for locomotion on
admission. The daily wheelchair self-propulsion distance was measured
using a cycle computer that was connected to a touch switch to exclude
the assistance-propulsion distance. The outcome measures were
represented as the relative gain of the Functional Independence Measure
(FIM) effectiveness during hospitalization. Moreover, a better
functional recovery was defined as a FIM effectiveness > 50%.
Participants were categorized into three groups according to tertiles of
the average daily wheelchair self-propulsion distance: lowest tertile
(T1, ≤0.59 km/day); middle tertile (T2, 0.60–1.23 km/day); and highest
tertile (T3, ≥1.24 km/day).
Results
Multivariate logistic regression analysis adjusted for baseline
characteristics showed that the T2 and T3 groups had a significant
association with better FIM effectiveness, and their odds ratios (95%
confidence interval, p) were 7.26 (1.13–45.85, p = .038), and 10.19 (1.15–91.75, p = .035), respectively.
Conclusions
The daily wheelchair self-propulsion distance was significantly
associated with functional recovery in subacute stroke survivors.
IMPLICATIONS FOR REHABILITATION
-
Non-ambulatory
stroke survivors can obtain extra independent physical activity by
using wheelchair self-propulsion, when they do not have someone to
assist them with walking.
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This
multicenter observational study revealed that the self-propulsion
distance of a manual-wheelchair was significantly associated with
functional recovery in subacute stroke survivors.
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