OBJECTIVE: This study was carried out to help the comprehensive rehabilitation of cervical cord injuries by measuring propulsion force and endurance on their wheelchair hand- rims, predicting the differences between neurological levels and analysing the factors which contributed to maintain the wheelchair propulsion force. METHOD: The BTE work simulator was used on 17 cervical cord injuries to test the force and endurance during wheel chair propulsion. The 141 large wheel of BTE work simulator and standard wheelchair which was removed handrims was used for simulating wheelchair propulsion. Wilcoxon rank sum test was used to compare force and endurance among the groups. RESULTS: The wheelchair propulsion force and endurance showed significant differences between neurological levels and types of the life style. The lower the level, the higher the strength and endurance (p<0.001). The wheelchair propulsion force of cervical cord injuries showed statistically significant differences between those with and without jobs (p<0.05). The outdoor wheelchair users and wheelchair propulsion exercise group showed significantly high maximum isometric strengths compared to the indoor users and the only ROM exercise group, respectively (p<0.05). CONCLUSION: During the rehabilitation period cervical cord injured persons need the wheelchair propulsion exercise using BTE work simulator to improve the quality of life.
Humans ; Life Style ; Quality of Life ; Rehabilitation ; Wheelchairs*

OBJECTIVE: To evaluate the force, endurance and influencing factors for wheelchair propulsion in paraplegics using BTE work simulator, and to find out a better method improving fitness levels for the paraplegics. METHOD: Seventeen paraplegic men were enrolled for the study. Isometirc and isotonic strength and dynamic endurance levels for wheelchair propulsion were measured using BTE work simulator. Neurological and demographical characteristics of patients were collected by personal interviews and direct examinations. RESULT: The spinal cord injured level showed a significant correlation with dynamic endurance (r=0.503, p<0.05) but not with the isometric and isotonic strength. The total duration of wheelchair use showed a significant correlation with the isotonic strength (r=0.497, p<0.05), but not with the isometric strength and dynamic endurance. The age and outdoor activities or exercise time during one week showed no significant correlation. CONCLUSION: Spinal cord injured level positively correlated with dynamic endurance. Both cardiorespiratory effect and trunk balance may influence this correlation. The total duration of wheelchair use wasn't correlate with dynamic endurnace. It seems to be more advisable trunk balance training goes with dynamic endurance training in rehabilitation program.
Humans ; Male ; Rehabilitation ; Spinal Cord ; Wheelchairs*

OBJECTIVE: To assess the effects of backrest inclination of a wheelchair on buttock pressures in spinal cord injured (SCI) patients and normal subjects. METHOD: The participants were 22 healthy subjects and 22 SCI patients. Buttock pressures of the participants were measured by a Tekscan(R) pressure sensing mat and software while they were sitting in a reclining wheelchair. Buttock pressures were recorded for 90degrees, 100degrees, 110degrees, 120degrees and 130degrees seat-to-back angles at the ischial tuberosity (IT) and sacrococcygeal (SC) areas. Recordings were made at each angle over four seconds at a sampling rate of 10 Hz. RESULTS: The side-to-side buttock pressure differences in the IT area for the SCI patients was significantly greater than for the normal subjects. There was no significant difference between the SCI patients and the normal subjects in the buttock pressure change pattern of the IT area. Significant increases in pressure on the SC area were found as backrest inclination angle was changed to 90degrees, 100degrees and 110degrees in the normal subjects, but no significant differences were found in the SCI patients. CONCLUSION: Most of the SCI patients have freeform posture in wheelchairs, and this leads to an uneven distribution of buttock pressure. In the SCI patients, the peak pressure in the IT area reduced as the backrest angle was increased, but peak pressure at the SC area remained relatively unchanged. To reduce buttock pressure and prevent pressure ulcers and enhance ulcer healing, it can be helpful for tetraplegic patients, to have wheelchair seat-to-back angles above 120degrees.
Buttocks ; Humans ; Posture ; Pressure Ulcer ; Spinal Cord ; Ulcer ; Wheelchairs

Psoriatic arthritis is an uncommon disease in the community and probably occurs in no more than 5 percent of the general psoriatic population. The authors experienced a patient who had the findings of mutilating type of psoriatic arthritis with severe joint deformities. A 30 year-old man was admitted to our hospital due to multiple joint pain and deformities with wheel chair bound state. We report a case of mutilating type in the psoriatic arthritis with brief review of literatures.
Adult ; Arthralgia ; Arthritis, Psoriatic* ; Congenital Abnormalities ; Humans ; Joints ; Wheelchairs

OBJECTIVE: To examine changes in seat-interface pressure in wheelchair seated spinal cord injured patients. METHOD: Twenty-six spinal cord injured patients, who were motor complete tetraplegic and paraplegic patients, were included in this study. After 5 cm air-filled cushion (ROHO(R)) was placed on their own wheelchair seat, patients were seated on wheelchair with neutral position for sixty minutes. The interface pressure and contact area of buttock was measured every 5 minutes. RESULTS: Significant increases of interface pressure were found in maximal and mean interface pressure during 0 to 25 minutes of sitting (p<0.05). An increased tendency of contact area of buttock was observed during sitting time but it was not significant. CONCLUSION: There were no significant changes of interface pressure after 25 minutes of sitting in spinal cord injured patients. Therefore, twenty-five minutes may be a reasonable sitting time before interface pressure is recorded.
Buttocks ; Humans ; Spinal Cord ; Spinal Cord Injuries ; Wheelchairs

INTRODUCTION: There are insufficient researches about the causes and the actual condition of fracture in Hansen's disease. Hence, I would like to indicate the problem by analysing the actual condition of fractures in Sorocdo Hansen's disease and a link between electromotion scooter and fracture. MATERIAL AND METHODS: Object is 75 patients who were admitted at Sorocdo National Hospital due to fracture from 2003, January to 2006, December. The medical record was analysed by retrospectively. Patient's general feature and the feature related to accident were analysed. Moreover, use of electromotion scooter and the relation between them were researched. RESULTS: The proportion of males to females is 1.41:1. Average age is 73.6 and over 65 years old shows 78.7%(59 persons) which means fracture happens frequently at old age. Predominant percentage of fracture is occurred at summer(34.7%) and autumn(33.4%). In addiction, the number of fracture patients is increased surprisingly since electromotion wheelchair and scooter were introduced in 2005. Hip joint fracture(34.7%) and distal radius fracture (16.0%) are the main region. The major reasonsof fracture are falls(52.2%) and accidents related to electromotion scooter(17.9%). The mortality of patients who were treated surgically(4.9%) is meaningfully lower than that who received conservated treatment(23.5%). CONCLUSION: The aged population and the number of electromotion scooter are been increasing in Sorocdo. Therefore, We need to find the fundamental and specific measure to prevent fracture caused by falls and electromotion scooter accident. Furthermore, surgical treatment is required actively.
Female ; Hip Joint ; Humans ; Leprosy ; Male ; Medical Records ; Mortality ; Radius Fractures ; Retrospective Studies ; Wheelchairs

This paper reports a rare case of a lumbosacral dislocation associated with symphysis pubis separation and cauda equina syndrome. A 39-year-old male who diagnosed traumatic lumbosacral dislocation underwent an open reduction without fusion. After an open reduction and internal fixation of a symphysis pubis separation, a missed lumbosacral dislocation was diagnosed and an open reduction was performed without fusion. Due to the symphysis pubis separation, the patient was not allowed weight bearing for 3 months, which then began from wheel chair ambulation. At the 6-month follow up evaluation, there was no back pain but the patient reported mild S1 nerve root sensory symptoms. Lumbosacral dislocation is common in high energy polytrauma patients and can be misdiagnosed. However, prompt reduction without fusion is a good alternative treatment.
Adult ; Back Pain ; Cauda Equina ; Dislocations ; Follow-Up Studies ; Humans ; Male ; Polyradiculopathy ; Walking ; Weight-Bearing ; Wheelchairs

OBJECTIVE: To investigate the shoulder disease patterns for the table-tennis (TT) and archery (AR) wheelchair athletes via ultrasonographic evaluations. METHODS: A total of 35 wheelchair athletes were enrolled, made up of groups of TT (n=19) and AR (n=16) athletes. They were all paraplegic patients and were investigated for their wheelchair usage duration, careers as sports players, weekly training times, the Wheelchair User's Shoulder Pain Index (WUSPI) scores and ultrasonographic evaluation. Shoulders were divided into playing arm of TT, non-playing arm of TT, bow-arm of AR, and draw arm of AR athletes. Shoulder diseases were classified into five entities of subscapularis tendinopathy, supraspinatus tendinopathy, infraspinatus tendinopathy, biceps long head tendinopathy, and subacromial-subdeltoid bursitis. The pattern of shoulder diseases were compared between the two groups using the Mann-Whitney and the chi-square tests RESULTS: WSUPI did not significantly correlate with age, wheelchair usage duration, career as players or weekly training times for all the wheelchair athletes. For the non-playing arm of TT athletes, there was a high percentage of subscapularis (45.5%) and supraspinatus (40.9%) tendinopathy. The percentage of subacromial-subdeltoid bursitis showed a tendency to be present in the playing arm of TT athletes (20.0%) compared with their non-playing arm (4.5%), even though this was not statistically significant. Biceps long head tendinopathy was the most common disease of the shoulder in the draw arm of AR athletes, and the difference was significant when compared to the non-playing arm of TT athletes (p<0.05). CONCLUSION: There was a high percentage of subscapularis and supraspinatus tendinopathy cases for the non-playing arm of TT wheelchair athletes, and a high percentage of biceps long head tendinopathy for the draw arm for the AR wheelchair athletes. Consideration of the biomechanical properties of each sport may be needed to tailor specific training for wheelchair athletes.
Arm ; Athletes* ; Bursitis ; Head ; Humans ; Pilot Projects* ; Shoulder Pain ; Shoulder* ; Sports ; Tendinopathy ; Ultrasonography ; Wheelchairs*

PURPOSE: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. MATERIALS AND METHODS: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. RESULTS: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). CONCLUSION: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.
Early Ambulation ; Femur ; Fractures, Spontaneous ; Humans ; Lower Extremity ; Postoperative Complications ; Postoperative Hemorrhage ; Skeleton ; Tibia ; Walking ; Wheelchairs

The purpose of this study was to investigate the effect of wheelchair ergometer training on spinal cord-injured paraplegics. Eleven male paraplegics with a mean age of 30.9 years (range, 20 to 49 years) participated in the wheelchair ergometer training for the period of 5 weeks. The mean peak heart rate, the mean peak systolic blood pressure and the mean time required for 100m wheelchair propelling at resistance level 1 were significantly decreased at the end of 5 weeks of training as compared with those at pre-training. There was no statistically significant difference in pulmonary function test at pre- and post-training. The peak torque of shoulder flexor and the total work of shoulder flexor and extensor at 180 degrees/sec after training were increased more significantly than those prior to the training. In accordance with the findings as revealed above, it is deemed that the endurance and strength of the upper body and the cardiac fitness for spinal cord-injured paraplegics may be improved by the wheelchair ergometer exercise
Adult ; *Exercise Therapy ; Human ; Male ; Middle Age ; Paraplegia/etiology/*rehabilitation ; Spinal Cord Injuries/complications/*rehabilitation ; *Wheelchairs