Role of the wheelchair in the management of the muscular dystrophy patient.

During the postambulatory period, patients with pseudohypertrophic muscular dystrophy depend entirely on their wheelchairs for comfort and spinal support. Without the comfort they are unable to enjoy and participate in every waking activity; without the spinal support they are destined to accept a bedbound life, not so much by the actual weakness as by the progression of spinal deformity. Present-day wheelchairs are not comfortable and they do not provide adequate spinal support. A novel spinal support system (brace) has been prescribed for 50 patients during the last 24 months. It consists of a contoured seat, mounted on a modified wheelchair frame, with integral armrests, footrests and headrest. All patients are clearly more comfortable and spend between 9 and 14 hours a day in their special wheelchairs, compared with 2 to 3 hours at a time in standard wheelchairs. Parents, teachers and therapists have reported a definite improvement in the attitudes of these patients. Although we have measured no progression in spinal deformity and have recorded regression in a few patients, we cannot yet assess the final value of this promising method of support in preventing spinal collapse.