Motion Analysis of Wheelchair Propulsion Movements of Hemiplegic Patients:Effect of a Wheelchair Cushion on the Initiation of Propulsion

Abstract

The objective of this study was to study the effect on the initiation of wheelchair propulsion from stationary sitting when pelvic posterior tilt was inhibited by a wheelchair cushion. [Subjects] The subjects were 18 hemiplegic patients who were capable of sitting in, and propelling a wheelchair. [Method] We used electromyography and a 3D motion analysis system to measure the posterior pelvic tilt angle, the muscle activity of the long head of the biceps femoris (BFLH), and the propulsion speed in the initiation of wheelchair propulsion from stationary sitting with three different types of cushion. [Results] The cushion which had the thigh pad removed on the propulsion side, having an anchor function, inhibited posterior pelvic tilt during initiation of propulsion from stationary sitting, BFLH activity was low, and fast propulsion was enabled. [Conclusion] The results suggest that inhibiting posterior pelvic tilt in stationary wheelchair sitting influences the propulsion initiation action.

Trunk function in hemiplegic wheelchair users when using wheelchair cushions

“…We have previously confirmed that wheelchair cushions with anchoring functionality and a removable thigh pad on the driving side are able to suppress posterior pelvic tilt when sitting still, that the period from sitting still until the start of driving is important 3 ) , and that this effect continues until immediately after the start of driving 4 ) . From the above, we considered that it was necessary to investigate adapting wheelchair cushions based on trunk functionality from a single-legged driving motion.…”

Motion analysis of wheelchair propulsion movements in hemiplegic patients: effect of a wheelchair cushion on suppressing posterior pelvic tilt

“…Thus, the results of anchoring the cushion and removing the thigh pad from the propulsion side in the present study showed results similar to those of the studies by Takeda et al 6 ) , Cron 9 ) , and Engstrom 15 ) . Furthermore, the effect of a wheelchair cushion suppressing pelvic posterior tilt when sitting still as investigated by Kawada et al 12 ) was shown to continue through the third propulsion cycle. We also found that the effect continued through to the third propulsion cycle, and it was possible to quantitatively express the pelvic posterior tilt angle over time.…”

“…We assumed that age and sex differences would have a negligible effect on the results. Although such effects are a possibility, previous studies that were mixed sex and that considered a broad range of ages have not reported age or sex differences 11 , 12 ) .…”

“…We used the same wheelchair cushion in this study as in our previous study 12 ) . The cushion had an anchoring function, and the thigh pad on the propulsion side was removed.…”

“…However, these reports often use propulsion speed as an evaluation indicator, and there are no reports that have quantitatively evaluated the angle of pelvic posterior tilt. We previously found that pelvic posterior tilt could be suppressed by using a wheelchair cushion in hemiplegics under the conditions of being seated without moving up to initiation of proplusion 12 ) . However, this effect of the cushion needs to be examined in more detailed by investigating how the angle of pelvic posterior tilt changes under the conditions of being seated through initiation and continuation of propulsions.…”