Functional ability and equipment use among patients with neuromuscular disease

The relationship between graded functional ability of a neuromuscular disease patient and his routine daily activities remains unknown. Mobility equipment use may provide an indirect measure of routine daily activities. In this study 110 neuromuscular disease patients were evaluated for both functional grade (Brooke upper extremity and Vignos lower extremity scales) and equipment use. Although several of the Vignos and Brooke categories did not describe significant numbers of these patients, the Vignos scale was able to predict whether or not a given patient would use a wheelchair with 94% accuracy, while the Brooke scale was only 85% accurate. It was not possible to predict manual vs electric wheelchair use based on functional rating scores. Patients with proximal weakness, regardless of diagnosis, displayed a similar pattern of functional outcome and equipment use, which was significantly different from the pattern displayed by groups with distal weakness. As expected, as functional ability diminished, wheelchair use increased; however, wheelchair use began at surprisingly high functional levels. Patients generally preferred a combination of manual and electric wheelchair use.