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

BACKGROUND

The Philippine General Hospital (PGH) is a tertiary government hospital that serves as the national referral center for Filipinos from across the country. In partnership with Latter-Day Saint Charities (LDSC), PGH has been serving patients in need of mobility devices, such as wheelchairs, through in-person services from screening to assessment, measurement, assembly, fitting, and mobility training. Given the patients’ barriers to in-person follow-up consultations, regular healthcare provision has been challenging. The use of telerehabilitation, a form of telemedicine, has emerged as a practical and innovative solution, but it needs further evaluation.

The study aimed to determine the wheelchair recipients’ perceived barriers to in-person and virtual follow-up consultations.

This cross-sectional study involved a purposive sample of 413 patients who received a wheelchair from the LDSC through PGH. An original survey was prepared to determine patients’ perceived barriers to actual in-person and potential virtual follow-up consultations. Consent was obtained prior to data collection. After the pretest and pilot testing were conducted, the final version of the survey was administered either electronically or through individual phone interviews. Descriptive statistics was used to analyze and present the data.

A total of 113 wheelchair recipients participated, with an average of 42.9 years of age. The majority resided outside Metro Manila (53.1%), and 86.7% were within the income bracket of less than PhP 9,520 per month. The majority received a standard type of wheelchair (85.8%). The top 3 reasons hindering compliance to in-person consultation follow-ups were accessibility issues (82.3%), costs of travel (79.6%), and distance to hospital/wheelchair assessor (71.7%). With respect to potential virtual follow-ups, 72% expressed willingness to experience telemedicine/telerehabilitation in the future, despite having neither prior awareness (50.4%) nor experience (74.3%) of it. The majority had access to mobile phones (98.2%), and 67% had stable internet access.

The main barriers to in-person follow-ups were related to accessibility, costs, and travel. Telehealth or telerehabilitation in particular, despite patients’ interest and willingness to try it, still has yet to be optimized in our country. Internet connectivity can still be improved, as well as our stakeholders’ level of telehealth awareness. Future efforts to improve and sustain the uptake of telehealth solutions are recommended, as well as studies comparing the cost-effectiveness of in-person versus virtual consultations especially among persons with lived experiences of disability.

OBJECTIVES: The purpose of this study is to examine relationship between an amount of key tasks and job satisfaction among caregivers and nurses in elderly care facilities. METHODS: Questionnaires were mailed to the caring staff of elderly care facilities. After data collection (return rate 70%), information about work situations and health conditions were analyzed among 325 female workers, who were classified to 4 groups as follows; (1) caregivers under 40 years of age (2) caregivers of 40 years or over (3) nurses under 40 years of age (4) nurses of 40 years or over. RESULTS: Mean ages and length of career in caring sector were 37.2 +/- 12.2 yr and 4.5 +/- 3.0 yr for caregivers and 41.6 +/- 9.2 yr and 16.8 +/- 8.9 yr for nurses, respectively. A larger amount of care services were done on average by workers being dissatisfied with their job than by the satisfied workers in each of the 4 groups. The dissatisfied caregivers under 40 years showed significantly higher frequencies (as ratios of 1.4 - 2 to 1) in several care services such as "helping with showers or baths", "helping with eating", "changing diapers", "moving caretakers from bed or chair to wheelchair or vice versa", as compared with the satisfied caregivers under 40 years. Similarly, the 40 plus dissatisfied caregivers helped caretakers sit up in bed significantly more frequently. For nurses, on the other hand, "changing diapers" was found as the only service with a significant difference in frequency between the dissatisfied and the satisfied, but that was limited in the 40 plus age group. A frequency of "changing diapers" was associated with an increase in the risk of job dissatisfaction. CONCLUSIONS: These results suggested that an appropriate amount of each key task in elderly care facilities should be set to prevent staff\'s dissatisfaction with their job from growing excessively.
Aged* ; Caregivers* ; Data Collection ; Female ; Hand ; Humans ; Job Satisfaction* ; Postal Service ; Wheelchairs

OBJECTIVE: To evaluate changes in activity of daily living before and after provision of electric-powered indoor/outdoor chair (EPIOC), discuss problems of current activities of daily living (ADL) evaluating tools for EPIOC users, and provide preliminary data to develop ADL evaluation tool for EPIOC user. METHODS: A total of 70 users who were prescribed EPIOC and had been using for more than 1 year were recruited in this study. Before and after provision of EPIOC, MBI and FIM scores were measured and a questionnaire consisting of six categories (general socioeconomic states, currently using state, whether EPIOC was helpful for social participation and occupational chances, psychiatric influences, self-reported degrees of independency, and barriers of using EPIOC) was used. RESULTS: No difference in MBI scores before and after provision of EPIOC was observed. However, the wheelchair ambulation category showed a significant difference. While motor FIM was not significantly different from MBI, FIM score were significantly (p<0.05) higher than MBI. For questions regarding social participation frequency, helpfulness of EPIOC on confidence, refreshing patients' emotions and self-reported degrees of independence, all of them showed positive responses. Especially, EPIOC users' self-reported degree of independency showed favorable results. There was discrepancy in MBI or FIM measured by physicians. CONCLUSION: Our study showed that there was a gap between the existing ADL evaluation tool and the ADL level that EPIOC users were actually feeling. Thus, it is necessary to develop an evaluation tool specifically for EPIOC.
Activities of Daily Living ; Disability Evaluation ; Self-Help Devices ; Social Participation ; Walking ; Wheelchairs ; Surveys and Questionnaires

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

OBJECTIVE: To compare transverse abdominis (TrA) contractility in stroke patients with hemiparesis and healthy adults using musculoskeletal ultrasonography. METHODS: Forty-seven stroke patients with hemiparesis and 25 age-matched healthy control subjects participated in this study. Stroke patients were divided into three groups on the basis of their degree of ambulation. Group A consisted of 9 patients with wheelchair ambulation, group B of 23 patients with assisted ambulation, and group C of 15 patients with independent ambulation. Inter-rater reliability regarding ultrasonographic measurement of abdominal muscle thickness in the control group was assessed by two examiners. The TrA contraction ratio (TrA contracted thickness/TrA resting thickness) was measured during abdominal drawing-in maneuver and was compared between the patients and the control group and between the ambulation groups. RESULTS: The inter-rater reliability ranged from 0.900 to 0.947. The TrA contraction ratio was higher in the non-paretic side than in the paretic side (1.40+/-0.62 vs. 1.14+/-0.35, p<0.01). The TrA contraction ratio of the patient group was lower in the non-paretic side as well as in the paretic side than that of the control group (right 1.85+/-0.29, left 1.92+/-0.42; p<0.001). No difference was found between the ambulation regarding the TrA contraction ratio. CONCLUSION: The TrA contractility in hemiparetic stroke patients is significantly decreased in the non-paretic side as well as in the paretic side compared with that of healthy adults. Ultrasonographic measurement can be clinically used in the evaluation of deep abdominal muscles in stroke patients.
Abdominal Muscles ; Adult ; Humans ; Muscle Contraction ; Paresis ; Stroke* ; Ultrasonography ; Walking ; Wheelchairs