Wheelchair charity: A useless benevolence in community-based rehabilitation

PURPOSE: Hand rim-propelled manual wheelchairs (WC) are conventionally distributed to persons with dysfunctioning lower limbs for independent ambulation in community-based rehabilitation. The purpose of the present study was to survey the fate of the donated WCs and the difficulties encountered by the users by identifying the cause of rejection, and to evaluate the performance by assessing physiological strain on the recipients during their routine ambulation using cardiorespiratory parameters. METHODS: Personal interview was arranged for the recipients and they were to answer regarding the fate of the donated WC and the cause of rejection for the recipients who rejected their WC. A simple field test was also administered to the users to evaluate the ambulatory performance using the WC. The energetics of WC propulsion at freely chosen speed was studied. RESULTS: Of the WC, 10.49% were for attendant-dependent ambulation, 57.4% were not used, 14.19% were sold and 7.4% were in regular use and 10.5% in occasional use. Most of the recipients rejected their WC due to pain, fatigue and discomfort and lack of habitat adaptability. The cardiorespiratory response was higher in occasional users than regular users. Locomotive tasks using WC are highly energy demanding and contribute to physiological strain. CONCLUSIONS: Hand rim-propelled manual WC are unsuitable for outdoor ambulation due to low speed and high physiological demand; they are also of little use indoors as they are difficult to maneuver under the environmental conditions and architectural restraints. So, they should not be recommended without proper assessment of the user's activity level and requirements.