Evaluation of functional electrical stimulation-assisted leg-propelled wheelchair in hemiplegic patients

Background: Manual wheelchairs are an important mobility device for hemiplegic stroke patients, but understandably difficult to operate. A novel mobility device termed the functional electrical stimulation-assisted leg-propelled wheelchair (FES-LW) was proposed and a field test conducted to evaluate its clinical performance by comparison against a manual wheelchair (MW). Methods: A total of 20 hemiplegic patients were recruited from the National Cheng Kung University Hospital. They were instructed to successively propel the FES-LW and MW comfortably, as fast as possible, in along an oval pathway. The finish time, deviation frequencies, deviation percentage, physiological cost index (PCI), and modified Ashworth scale (MAS) of affected ankle were measured and compared. Findings: Subjects can propel the FES-LW with 40.1% less finish time (P = 0.003); 23.7% lower deviation frequencies (P = 0.009) and 36.7% lower deviation percentage (P = 0.001); and 17.7% lower PCI (P = 0.022) than the MW. In addition, the MAS of the affected ankle was noticeably reduced (P = 0.002) after propelling the FES-LW. Interpretation: The FES-LW showed better controllability, cardiopulmonary response and positive effects on reducing spasticity versus the MW. The FES-LW is a suitable alternative to a MW for the needs of hemiplegic stroke patients.