Development of a Method for Transferring Paraplegic Patients with Advanced Cancer from Bed to Wheelchair

• Published in: Journal of palliative medicine Vol. 19; no. 6; p. 656
• Main Authors: Abe, Kazunari, Okamura, Hitoshi
• Format: Journal Article
• Language: English
• Published: United States 01.06.2016
• Subjects: Activities of Daily Living; Humans; Neoplasms; Pain; Paraplegia; Wheelchairs
• ISSN: 1557-7740
• DOI: 10.1089/jpm.2015.0345

For patients with traumatic paraplegia, the ability to push up is a prerequisite for basic movements, including the transfer from bed to wheelchair. However, this movement may be contraindicated in patients with advanced cancer with bone metastases because of the risk of pain and pathologic fractures and muscle weakness resulting from cancer cachexia and disuse syndrome. The purpose of this study was to develop a method for transferring paraplegic patients from bed to wheelchair taking into consideration the unique characteristics of patients with advanced cancer with bone metastases and investigate the usefulness of said method. We developed a system for safe transfer from bed to wheelchair of paraplegic patients with advanced cancer consisting of horizontal transfer of the patient with safety apparatus utilizing an electric motor and potential energy. This method was used in 25 patients with advanced cancer and paraplegia. The activities of daily living (ADL), success/failure of transfer, ability for overnight stays outside the hospital, and possibility of discharge were investigated. Use of the newly developed transfer method caused no difficulties and the ADL scores were significantly increased (p < 0.001). In all, 64% of the subjects could be transferred successfully from bed to wheelchair; 60% had successful overnight stays outside the hospital, and 48% could be discharged. Our findings suggest that the use of our newly devised system enables transfer from bed to wheelchair of even those patients with advanced cancer who cannot resume walking in the upright position because of paraplegia.