Article

Objective: To determine the (dis)advantages of transition to a power-assisted
wheelchair, and derive the clinical implications for its use or prescription.
Data sources: Relevant articles published prior to May 2012
were identified using
PubMed, Cochrane Library, REHABDATA, CIRRIE and CINAHL databases. Review methods:
Clinical or (randomized) controlled trials, published in a peer-reviewed journal,
comparing power-assisted wheelchair use and hand-rim or powered wheelchair use
were eligible. Data quality and validity were assessed by two reviewers
independently using the Checklist for Measuring Quality developed by Downs and
Black. Results: A systematic search yielded 15 cross-over trails with repeated
measurement design and one qualitative interview. Methodological quality scored
between 9 and 15 points out of the maximum score of 32. Ten studies measuring
body function and structure reported reduced strain on the arm and cardiovascular
system during power-assisted propulsion compared to hand-rim propulsion. Twelve
studies measuring activities and social participation reported precision tasks
easier to perform with a hand-rim wheelchair and tasks which require more torque
were easier with a power-assisted wheelchair. Social participation was not
altered significantly by the use of a hand-rim, powered or power-assisted
wheelchair. Conclusion: Power-assisted propulsion might be beneficial for
subjects in whom independent hand-rim wheelchair propulsion is endangered by arm
injury, insufficient arm strength or low cardiopulmonary reserves. Also, subjects
who have difficulty propelling a wheelchair in a challenging environment can
benefit from power-assisted wheelchair use.
Caution is warranted for the
additional width and weight in relation to the usual mode of transportation and
access to the home environment.

Langue : ANGLAIS