Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion

Boninger, Michael L.; Souza, Ana Paula Ramos de; Cooper, Rory A.; Fitzgerald, Shirley G.; Koontz, Alicia M; Fay, Brian T.

doi:10.1053/apmr.2002.32455

Cited by 261 publications

(241 citation statements)

References 18 publications

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“…However, the literature has reported that a large range of cadences and push angles often occurs within representative populations of wheelchair users (49)(50)(51). More specifically, a study completed comparing the propulsion techniques of long-term wheelchair users found that, at a given speed, the average group cadence varied from 1.1 to 1.6 stroke/s, and the push angle varied from 102 to 134 degrees (49). The significant group variability indicates that there is considerable room for improvement.…”

Section: Discussionmentioning

confidence: 99%

Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

Rice

Gagnon

Gallagher

et al. 2010

The Journal of Spinal Cord Medicine

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Background/Objective: As considerable progress has been made in laboratory-based assessment of manual wheelchair propulsion biomechanics, the necessity to translate this knowledge into new clinical tools and treatment programs becomes imperative. The objective of this study was to describe the development of a manual wheelchair propulsion training program aimed to promote the development of an efficient propulsion technique among long-term manual wheelchair users. Methods: Motor learning theory principles were applied to the design of biomechanical feedback-based learning software, which allows for random discontinuous real-time visual presentation of key spatiotemporal and kinetic parameters. This software was used to train a long-term wheelchair user on a dynamometer during 3 low-intensity wheelchair propulsion training sessions over a 3-week period. Biomechanical measures were recorded with a SmartWheel during over ground propulsion on a 50-m level tile surface at baseline and 3 months after baseline. Results: Training software was refined and administered to a participant who was able to improve his propulsion technique by increasing contact angle while simultaneously reducing stroke cadence, mean resultant force, peak and mean moment out of plane, and peak rate of rise of force applied to the pushrim after training. Conclusions:The proposed propulsion training protocol may lead to favorable changes in manual wheelchair propulsion technique. These changes could limit or prevent upper limb injuries among manual wheelchair users. In addition, many of the motor learning theory-based techniques examined in this study could be applied to training individuals in various stages of rehabilitation to optimize propulsion early on.

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Section: Discussionmentioning

confidence: 99%

Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

Rice

Gagnon

Gallagher

et al. 2010

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

show abstract

“…One should bear in mind that, at a speed of 3km/h, approximately 45 pushes/min are made. Also, at higher propelling speeds, the push time shortens and the force rise time decreases, which has been mentioned as a serious risk factor for injury 19 and has led to research into mechanisms to reduce the peak force. 20,21 During the reaching task, those muscles necessary to elevate the arm forward (deltoideus) and to stabilize the arm (infraspinatus, supraspinatus, serratus anterior) were active.…”

Section: Muscle Forcesmentioning

confidence: 99%

Glenohumeral Contact Forces and Muscle Forces Evaluated in Wheelchair-Related Activities of Daily Living in Able-Bodied Subjects Versus Subjects With Paraplegia and Tetraplegia

Drongelen

Woude

Janssen

et al. 2005

Archives of Physical Medicine and Rehabilitation

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ABSTRACT. van Drongelen S, van der Woude LH, Janssen TW, Angenot EL, Chadwick EK, Veeger DH. Glenohumeral contact forces and muscle forces evaluated in wheelchair-related activities of daily living in able-bodied subjects versus subjects with paraplegia and tetraplegia. Arch Phys Med Rehabil 2005;86: 1434-40.Objective: To estimate the differences in glenohumeral contact forces and shoulder muscle forces between able-bodied subjects and subjects with paraplegia and tetraplegia during wheelchair-related activities of daily living (ADLs).Design: Kinematics and external forces were measured during wheelchair ADLs (level propulsion, weight-relief lifting, reaching) and processed by using an inverse dynamics 3-dimensional biomechanical model.Setting: Biomechanics laboratory. Participants: Five able-bodied subjects, 8 subjects with paraplegia, and 4 subjects with tetraplegia (Nϭ17).Interventions: Not applicable. Main Outcome Measures: Glenohumeral contact forces and shoulder muscle forces.Results: Peak contact forces were significantly higher for weight-relief lifting compared with reaching and level propulsion (PϽ.001). High relative muscle force of the rotator cuff was seen, apparently needed to stabilize the joint. For weight-relief lifting, total relative muscle force was significantly higher for the tetraplegia group than for the able-bodied group (Pϭ.022).Conclusions: Glenohumeral contact forces were significantly higher for weight-relief lifting and highest over the 3 tasks for the tetraplegia group. Without taking paralysis into account, more muscle force was estimated for the subjects with tetraplegia during weight-relief lifting.

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“…1,2 Other suggested risk factors for the development of shoulder pain are the duration of injury, age (ie older people have a higher risk than younger people), higher body mass index (BMI) [3][4][5] and wheelchair propulsion style. 6 However, research has been limited in terms of methodology and power. Most of the previous studies were cross-sectional and/or retrospective studies and focused on subjects who had a longer duration of the injury.…”

Section: Introductionmentioning

confidence: 99%

Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury

et al. 2005

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Study design: Prospective cohort study. Objectives: To study upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using subjects with a spinal cord injury (SCI) and its relation with lesion characteristics, muscle strength and functional outcome. Setting: Eight rehabilitation centers with an SCI unit in the Netherlands. Methods: Using a questionnaire, number, frequency and seriousness of musculoskeletal pain complaints of the upper extremity were measured. A pain score for the wrist, elbow and shoulder joints was calculated by multiplying the seriousness by the frequency of pain complaints. An overall score was obtained by adding the scores of the three joints of both upper extremities. Muscle strength was determined by manual muscle testing. The motor score of the functional independence measure provided a functional outcome. All outcomes were obtained at four test occasions during and 1 year after rehabilitation. Results: Upper extremity pain and shoulder pain decreased over time (30%) during the latter part of in-patient rehabilitation (Po0.001). Subjects with tetraplegia (TP) showed more musculoskeletal pain than subjects with paraplegia (PP) (Po0.001). Upper extremity pain and shoulder pain were significantly inversely related to functional outcome (Po0.001). Muscle strength was significantly inversely related to shoulder pain (Po0.001). Musculoskeletal pain at the beginning of rehabilitation and BMI were strong predictors for pain 1 year after in-patient rehabilitation (Po0.001). Conclusions: Subjects with TP are at a higher risk for upper extremity musculoskeletal pain and for shoulder pain than subjects with PP. Higher muscle strength and higher functional outcome are related to fewer upper extremity complaints.Spinal Cord (2006) 44, 152-159.

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Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion

Cited by 261 publications

References 18 publications

Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

Glenohumeral Contact Forces and Muscle Forces Evaluated in Wheelchair-Related Activities of Daily Living in Able-Bodied Subjects Versus Subjects With Paraplegia and Tetraplegia

Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury

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