Article

Objective: To test the hypothesis that able-bodied people simulating hemiplegia (using the hemiplegic-propulsion pattern [1 ann and I leg]) have as much difficulty performing wheelchair skills as people with hemiplegia. Design: Single-blind, controlled comparison of 2 groups. Setting: Kinesiologic laboratory in a rehabilitation center. Participants: Twenty wheelchair users with hemiplegia (HP group) (median age, 68y; 80% men) and 20 able-bodied participants (AB group) (median age, 67y; 75% men). Interventions: The participants in the AB group simulated hemiplegia and received a brief period of wheelchair skills training. Participants in both groups were asked to attempt the 50 skills of the Wheelchair Skills Test, version 2.4 (WST 2.4). Main Outcome Measures: Total and subtotal percentage scores on the WST 2.4 and success rates for the 50 individual skills. Results: The mean percentage WST scores for the AB group were significantly greater than those for the HP group for the total WST scores (P < .001), the indoor skill level (P < .001), and the community skill level (P < .001), but the advanced skill level scores were 0% for both groups. On the individual skills, the AB group had success rates at least 25% higher than the HP group for 13 (26%) of the skills. Both groups were generally successful (greater than or equal to75% success rate) on 21 skills (42%). Both groups experienced difficulties (less than or equal to 50% success rate) on 13 skills (26%), notably those in which there was high rolling resistance (eg, incline ascent) or high balance demands (the wheelie skills). Conclusions: Both people with hemiplegia and able-bodied people who are simulating hemiplegia experience similar difficulties when performing some wheelchair skills. This suggests that there are difficulties inherent in these tasks, a finding that holds promise for solutions based on new techniques and technologies. (C) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

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