Use of a Pushrim-activated, Power-assisted Wheelchair Enhanced Mobility for an Individual with Cervical 5/6 Tetraplegia

For patients with mid-level (C5 or C6) tetraplegia, the choice between using a power or manual wheelchair is difficult because both types of wheelchairs have disadvantages. A new class of wheelchair has recently become available—the pushrim-activated, power-assisted wheelchair (PAPW)—which allows manual wheelchair propulsion with less effort. In this article the case of a patient with right C5, left C6 tetraplegia who practiced using both a manual wheelchair and a PAPW is presented. He achieved independence in manual wheelchair propulsion, but propulsion was slow and limited to short distances on smooth level surfaces. In contrast, he became independent in propelling the PAPW over a variety of surfaces for long distances at functional speeds, and in ascending and descending ramps. The patient's performance suggests that a PAPW is an alternative to a manual or power wheelchair for individuals with midlevel tetraplegia.