Dieruf Kathy, Ewer Lynette, Boninger David
Department of Orthopedics, University of New Mexico, Albuquerque, NM 87131, USA.
J Spinal Cord Med. 2008;31(5):578-85. doi: 10.1080/10790268.2008.11754605.
BACKGROUND/OBJECTIVE: People with spinal cord injury (SCI) may spend several decades using a wheelchair as their primary means of mobility. Secondary injury and a decline in independence over time are common with manual wheelchair users who, in turn, may require increased assistance as time passes. The Natural-Fit contoured handrim has been shown to improve symptoms and function in people with SCI who use manual wheelchairs and who have experienced upper extremity pain. The objective of this study was to determine the factors associated with improved symptoms and functions.
87 people who purchased the ergonomic wheelchair handrims. Participants were predominately men, with a median age of 51 to 55 years, median level of injury T10 to T12, median time in a wheelchair of 15 years, and they had used the contoured rims for 1 to 2 years.
This was a mail survey of 217 people who purchased the rims. The survey was mailed out from the manufacturer and was anonymously returned to the physical therapy department of a university. A $10 incentive was offered for returning the survey.
The majority of participants reported improvements in upper extremity symptoms, ease of wheelchair propulsion, and functional status. Longer use of the rims was associated with reported improvement in ease of wheelchair propulsion and reduction in pain in hands and wrists.
If a simple modification of the wheelchair can help bring about significant changes in the users' symptoms and function, this modification should be incorporated by people who use manual wheelchairs before decline in function begins. Proactive intervention may alleviate symptoms, help the person maintain maximal independence, and prolong the length of time the individual remains independent.
背景/目的：脊髓损伤（SCI）患者可能会在几十年的时间里将轮椅作为主要的移动工具。随着时间的推移，手动轮椅使用者常出现继发性损伤和独立性下降的情况，进而可能需要更多的帮助。自然贴合轮廓的手轮已被证明可改善使用手动轮椅且有上肢疼痛的脊髓损伤患者的症状和功能。本研究的目的是确定与症状和功能改善相关的因素。
87名购买了符合人体工程学的轮椅手轮的人。参与者以男性为主，年龄中位数为51至55岁，损伤水平中位数为T10至T12，使用轮椅的时间中位数为15年，他们使用轮廓手轮已有1至2年。
这是一项对217名购买了手轮的人的邮寄调查。调查问卷由制造商寄出，并匿名返回一所大学的物理治疗部门。返还调查问卷可获得10美元的奖励。
大多数参与者报告上肢症状、轮椅推进的 ease of wheelchair propulsion（此处原文有误，可能是ease of wheelchair propulsion的错误表述，推测应为“轮椅推进的轻松程度”）和功能状态有所改善。使用手轮的时间越长，报告的轮椅推进轻松程度的改善以及手部和腕部疼痛的减轻就越明显。
如果对轮椅进行简单改装就能帮助使用者的症状和功能发生显著变化，那么在功能开始下降之前，手动轮椅使用者就应该采用这种改装。积极干预可能会减轻症状，帮助使用者保持最大程度的独立性，并延长其保持独立的时间长度。
