Community use of a pushrim activated power-assisted wheelchair by an individual with facioscapulohumeral muscular dystrophy.

The purpose of this case study was to report data from a clinical evaluation of an individual with fascioscapulohumeral muscular dystrophy (FSHMD) while using a manual wheelchair versus the same wheelchair fitted with pushrim activated power-assisted wheelchair hubs (PAPAW). An individual with FSHMD was tested for change in heart rate (HR), rate of perceived exertion (RPE), propulsion speed (PS), time to completion (TC), and qualitative observation in a community-based environment. A modified Physiological Cost Index (mPCI) was calculated post hoc. Results indicate HR and mPCI for the PAPAW trials were lower; RPE was "Hard" for manual wheelchair propulsion and "Fairly or Very Light" for the PAPAW trials; PS was twice as fast in both conditions using the PAPAW; and TC was 53% faster with PAPAW than in the manual wheelchair. Qualitatively, the manual propulsion conditions had exaggerated trunk and hip flexion with simultaneous scapula elevation and upward rotation to initiate downward force on the hand rim more so than the PAPAW conditions. The data suggest that propulsion of a wheelchair enhanced by PAPAW is more energy efficient, biomechanically advantageous, and more timesaving than a manual wheelchair for the tested individual with FSHMD in his environment.