Speed and physiological cost index of hemiplegic patients pedalling a wheelchair with both legs.

OBJECTIVE To determine whether hemiplegic patients can propel a leg-pedalling wheelchair and whether it is easier and faster for them to pedal the wheelchair using both legs alternately than to propel an ordinary wheelchair with their unaffected hand and leg. DESIGN Within-subject comparison. SUBJECTS Subjects comprised 10 hemiplegic in-patients (8 males, 2 females), aged 63.7 (SD 12.7) years with severe or moderate gait disturbance due to stroke. METHODS Subjects were asked to practice propelling the leg-pedalling wheelchair and ordinary wheelchair on both slalom and rectangular courses for a period of 7-10 days. Once they had become skilled in this, the wheelchair speed and patient's heart rate were measured, and a physiological cost index was calculated. RESULTS Subjects could pedal the leg-pedalling wheelchair using both legs alternately. The speed of this wheelchair was faster than that of the ordinary wheelchair, and the physiological cost index for pedalling it was lower than that for propelling the ordinary wheelchair. However, subjects needed some help in transferring to the leg-pedalling wheelchair. CONCLUSION The hemiplegic patients could pedal the leg-pedalling wheelchair using both legs alternately faster and more effectively with regard to speed and physiological cost index.