Functional reach in wheelchair users: the effects of trunk and lower extremity stabilization

Our purpose was to compare the effects of using wheelchair trunk and lower extremity stabilization on sitting trunk mobility and functional reach of wheelchair users. Seven subjects with paraplegia who averaged 35.6 years of age and nine able-bodied control subjects with an average age of 26.0 years participated in this study. Each subject's functional reach in the transverse and sagittal planes was video-recorded in each of three conditions, randomized in order: (1) without a belt; (2) with a neoprene chest belt; and (3) with a webbing thigh belt. The area circumscribed by each subject's functional reach under each condition was processed using the Motion Analysis Expert Vision Flextrak program. Functional reach in each belting condition was compared within each subject and between able-bodied controls and subjects with high and low thoracic levels of paraplegia. This study showed that in the sagittal plane, subjects with both high and low thoracic levels of paraplegia were able to substantially increase the area of their functional reach when using a chest belt when compared with the thigh belt or no-belt condition. The mean area of their sagittal plane functional reach increased by over 50% by stabilizing the chest to the wheelchair using a neoprene belt. However, in the transverse plane, only those individuals with lower thoracic paraplegia (T8 to L1) gained substantial benefit from chest strapping, increasing the area of their functional reach by a mean of 24%. In contrast, able-bodied control subjects gained no benefit in functional reach from either belting condition.(ABSTRACT TRUNCATED AT 250 WORDS)