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Changes in skills required for using a manual wheelchair after reconstructive hand surgery in tetraplegia.

OBJECTIVE
The aim of this study was to document prospectively the changes in function that can affect the skills required to use a manual wheelchair after reconstructive hand and arm surgery in individuals with tetraplegia.


DESIGN
Case series. The tests were conducted preoperatively and 12 months postoperatively.


PATIENTS
Sixteen individuals who underwent a total of 23 grip/elbow extension reconstructions and who used a manual wheelchair as their main form of transport were included.


METHODS
Functional tests of wheelchair control were performed. The tests addressed 8 aspects of manoeuvring a wheelchair.


RESULTS
Sixty-eight percent of the individuals improved their manoeuvring skills after hand surgery. Improvements were also observed in the ability successfully to perform tests that were impossible to perform before surgery. The type of reconstruction and level of injury affected the outcome.


CONCLUSION
The improvement in wheelchair propulsion ability after reconstructive hand and arm surgery in individuals with tetraplegic spinal cord injury implies increased mobility, which can help individuals to live a more active life.