Manual wheelchair stroke characteristics during an extended period of propulsion

Abstract

Methods: Kinetic data were recorded from 21 subjects with paraplegia at four time points over the course of a 10-min propulsion trial at a steady state speed of 1.4 m s À1 . Upper extremity kinetic parameters were recorded using Smartwheels, force and torque sensing pushrims. Results: Subjects for propulsion biomechanics changed from early to late during the 10-min trial. Individuals displayed decreased maximum rate of rise of resultant force (P ¼ 0.0045) with a simultaneous increase in push time (P ¼ 0.043) and stroke time (P ¼ 0.023), whereas stroke frequency remained static. In addition, there was a decrease in out of plane moment application (P ¼ 0.032). Conclusion: Individuals seemed to naturally accommodate their propulsive stroke, using less injurious propulsion biomechanics over the course of a 10-minute trial on a dynamometer. The findings may have occurred as a result of both biomechanical compensations to a challenging propulsion trial and accommodation to propelling on a dynamometer. These results suggest that subjects may be capable of independently incorporating favorable biomechanical strategies to meet the demands of a challenging propulsion scenario.

Changes in surface electromyography signals and kinetics associated with progression of fatigue at two speeds during wheelchair propulsion

“…Rice et al reported an increase in push time during an extended period of propulsion, while stroke frequency remained static [42]. In the present study, no significant effects of kinetic variables on the endurance time of wheelchair propulsion were found.…”

The influence of wheelchair propulsion technique on upper extremity muscle demand: A simulation study

“…These studies found lower cadences increased mechanical efficiency and reduced self-reported perceived exertion measures, suggesting that lower demand is placed on the upper extremity (Goosey-Tolfrey and Kirk, 2003; Lenton et al, 2009). To our knowledge, only one study has investigated how altering contact angle influences wheelchair mechanics (using a single subject), but did not analyse specific measures of upper extremity demand (Rice et al, 2009). Potential reasons for the lack of studies may be due to the extreme difficulty in obtaining specific measures of upper extremity demand (e.g., muscle stress) or that longitudinal intervention studies can be confounded by other influences (e.g., physiological adaptation).…”

The Need for Updated Clinical Practice Guidelines for Preservation of Upper Extremities in Manual Wheelchair Users

“…In another study by Rice et al, 11 experienced users pushing for an extended period tended to propel with longer stroke lengths and reduced forces toward the end of a 10-min trial vs. at start-up. Many of these subjects were very experienced and seemed to place an emphasis on push efficiency and energy conservation toward the end of the extended trial.…”