Energy costs of one-arm-drive wheelchair propulsion: use of one arm versus one arm and ipsilateral leg

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Abstract
Patients disabled by a stroke may be prescribed a one-arm-drive wheelchair. However, these patients tend to use their good arm and leg to propel themselves rather than one arm only. In 11 normal subjects, we have found that the energy cost of self-propelling a one-arm-drive wheelchair at approximately 1 mph on a track which incorporated a component of steering was less when using both one arm and ipsilateral leg than when using one arm only. The converse was found during exercise on a treadmill where the steering component was eliminated. These differences were significant (p < 0.02) during propulsion at approximately 2mph (n = 8). Qualitatively similar results were obtained in six disabled patients exercising at approximately 1 mph. We conclude that additional use of a leg reduces energy expenditure by helping to steer the wheelchair. In stroke patients, however, ease of use consequent on cognitive impairment will also affect the choice of mode of propulsion.

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