Levy Charles E, Buman Matthew P, Chow John W, Tillman Mark D, Fournier Kimberly A, Giacobbi Peter
Department of Physical Medicine and Rehabilitation, Rehabilitation Outcomes Research Center, Gainesville, Florida, USA.
Am J Phys Med Rehabil. 2010 Aug;89(8):625-34. doi: 10.1097/PHM.0b013e3181e72286.
To evaluate the impact of power assist wheels on the distance traveled by manual wheelchair users and analyze potential cofactors in the magnitude of response and to test the hypothesis that wheelers would travel significantly further with power assist wheels.
A 16-wk A (Preintervention)-B (Intervention)-A (Postintervention) repeated measures design. Seven women and 13 men (age, 43 +/- 15 yrs) full-time wheelers participated. During the pre- and postintervention phases (4 wks each), participants used their own unaltered manual wheelchairs. During the 8-wk intervention phase, the manual wheels were replaced with power assist wheels. Daily distance was measured with bicycle-style odometers. A composite score of laboratory wheelchair tasks was used to classify wheelchair performance. Mixed model repeated measures analysis of variance analyzed changes across phases of the trial. A post hoc analysis tabulated the amount of days wheelers exceeded their individual daily averages in each phase by two SDs.
Wheelers traveled significantly greater distances during the intervention phase compared with pre- or postintervention phases regardless of baseline wheelchair performance. Wheelers who demonstrated higher baseline wheelchair performance traveled lesser average distances in the first 2 wks after receiving power assist wheels than in the subsequent 6 wks. Wheelers exceeded their individual daily averages per phase on a significantly greater number of days during the intervention phase.
Power assist wheels enabled wheelers to travel farther and to travel beyond their usual distances on more days. Further studies may be strengthened by taking into account the 2-wk "adjustment phase" for power assist wheels.
评估电动助力轮对手动轮椅使用者行进距离的影响，分析反应程度的潜在辅助因素，并检验使用电动助力轮的轮椅使用者行进距离会显著更远这一假设。
采用16周的A（干预前）-B（干预）-A（干预后）重复测量设计。七名女性和十三名男性（年龄43±15岁）全职轮椅使用者参与。在干预前和干预后阶段（各4周），参与者使用自己未改动的手动轮椅。在8周的干预阶段，将手动轮换成电动助力轮。使用自行车式里程表测量每日行进距离。采用实验室轮椅任务综合评分对轮椅性能进行分类。采用混合模型重复测量方差分析来分析试验各阶段的变化。事后分析列出了轮椅使用者在各阶段超过其个人每日平均距离两个标准差的天数。
无论基线轮椅性能如何，与干预前或干预后阶段相比，轮椅使用者在干预阶段行进的距离显著更远。基线轮椅性能较高的轮椅使用者在接受电动助力轮后的前2周平均行进距离比随后6周短。在干预阶段，轮椅使用者在更多天数内超过了其各阶段的个人每日平均距离。
电动助力轮使轮椅使用者能够行进得更远，并且在更多天数内超过其通常的行进距离。考虑到电动助力轮的2周“调整期”，可能会加强进一步的研究。
