In a left-hemiplegic patient of average height, a hemi or low seat height around 17.5 inches primarily facilitates propulsion by which limbs?

• A. Left upper extremity and left lower extremity
• B. Right upper extremity and left lower extremity
• C. Both upper extremities
• D. Right upper extremity and right lower extremity

Answer: (D)

When a patient has left-side paralysis, the right side is the functional one. With a hemi/low seat around 17.5 inches, propulsion is most effectively generated by the non-affected limbs: the right upper extremity drives the hand rim, and the right lower extremity can assist by pushing off from the floor or footrest. The lower seat height lets the foot make contact and contribute to forward movement, complementing the arm push. Using the left (paralyzed) limbs would limit force generation, so the strongest propulsion comes from the right upper and right lower extremities together.