Effect of choice of recovery patterns on handrim kinetics in manual wheelchair users with paraplegia and tetraplegia

Abstract

Background: Impact forces experienced by the upper limb at the beginning of each wheelchair propulsion (WCP) cycle are among the highest forces experienced by wheelchair users. Objective: To determine whether the magnitude of hand/forearm velocity prior to impact and effectiveness of rim impact force are dependent on the type of hand trajectory pattern chosen by the user during WCP. Avoiding patterns that inherently cause higher impact force and have lower effectiveness can be another step towards preserving upper limb function in wheelchair users. Methods: Kinematic (50 Hz) and kinetic (2500 Hz) data were collected on 34 wheelchair users (16 with paraplegia and 18 with tetraplegia); all participants had motor complete spinal cord injuries ASIA A or B. The four-hand trajectory patterns were analyzed based on velocity prior to contact, peak impact force and the effectiveness of force at impact. Results: A high correlation was found between the impact force and the relative velocity of the hand with respect to the wheel (P < 0.05). The wheelchair users with paraplegia were found to have higher effectiveness of force at impact as compared to the users with tetraplegia (P < 0.05). No significant differences in the impact force magnitudes were found between the four observed hand trajectory patterns. Conclusion: The overall force effectiveness tended to be associated with the injury level of the user and was found to be independent of the hand trajectory patterns.

Shoulder pain and jerk during recovery phase of manual wheelchair propulsion

“…The mean spatial-temporal wheelchair propulsion parameters observed in this investigation were consistent with previous literature (Boninger et al, 1997, Shimada et al, 1998, Boninger et al, 2002, Collinger et al, 2008, Richter et al, 2011, Raina, S et al, 2012, Slowik, J.S et al, 2015). This benchmarking was essential to suggest that the observations from our investigation are generalizable and qualitative comparison of our results with previous literature is acceptable.…”

The influence of speed and grade on wheelchair propulsion hand pattern

“…While differences in individual anthropometrics, strength and functional capacity among wheelchair users may prevent the identification of a single optimal hand pattern for all subjects (Raina et al, 2012), task-specific constraints and required upper extremity demand likely preclude the existence of a single optimal hand pattern for all tasks (Richter et al, 2007). …”

“…2). For the free condition, subjects performed level propulsion at their self-selected free speed (mean = 1.04 m/s, SD = 0.30 m/s) with the resistance level set similar to overground propulsion over a tile surface (e.g., Raina et al, 2012). For the fast condition, subjects performed level propulsion at their fastest comfortable speed (mean = 1.90 m/s, SD = 0.46 m/s).…”

Augmented Feedback for Manual Wheelchair Propulsion Technique Training in a Virtual Reality Simulator

“…Cognitive and psychological impairments such as de cits in attention and memory as well as depression and anxiety may negatively affect motor learning processes [57][58][59][60][61]. Additionally, acquisition of ideal propulsion technique may be hindered in many MWC users due to upper body motor impairments, such as limited trunk control and reduced grip strength [62,63]. For these reasons, ndings from this study may not translate directly to a clinical population of wheelchair users.…”