Wheelchair propulsion in the quadriplegic patient

It is suggested that many quadriplegic patients, are unable to propel their wheelchairs at a speed comparable to that of normal walking; if they are able they are limited in distance. Many of these patients also cannot handle ramps with a standard incline of 7 degrees. Therefore it is suggested that a patient's ability to propel his wheelchair at certain velocities over various distances and to handle the inclines encountered in his environment should be assessed in a clinical situation. This evaluation should then be used to determine whether the demand placed upon the patient by his environment would be such that he could effectively use a manually propelled wheelchair. In an evaluation of various wheelchair handrims it was found that the patients with lesions at low levels had the most effective force transmission using a standard metal handrim equipped with a spiral wrap of rubber tubing. In those having lesions at higher level, oblique or vertical pegs are to be preferred. Patients for whom a manually propelled wheelchair proves ineffective should resort to an electric wheelchair. The use of the electric wheelchair will, however, decrease the patient's long range mobility because of the difficulty of transferring the cumbersome appliance into a car.