Relationship between physical strain during standardised ADL tasks and physical capacity in men with spinal cord injuries

Janssen, Thomas W J; Oers, C. A. J. M. Van; Veeger, H.E.J.; Hollander, A. P.; Woude, Lucas H V van der; Rozendal, R. H.

doi:10.1038/sc.1994.131

Cited by 71 publications

(57 citation statements)

References 18 publications

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“…There is also the absence of sufficient recovery time: subjects must perform lifts during the day and propel themselves. Tasks like making a transfer are performed around 15 times a day, 1 and, as shown by Janssen et al, 32 a physical strain of 60% of the heart rate reserve occurs frequently during transfers. The high loads during ADL tasks might be a risk factor for overuse of the upper-extremity joint, which would be in line with epidemiologic data.…”

Section: Methodsmentioning

confidence: 99%

Mechanical Load on the Upper Extremity During Wheelchair Activities

Drongelen

Woude

Janssen

et al. 2005

Archives of Physical Medicine and Rehabilitation

144

110

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ABSTRACT. van Drongelen S, van der Woude LH, Janssen TW, Angenot EL, Chadwick EK, Veeger DH. Mechanical load on the upper extremity during wheelchair activities. Arch Phys Med Rehabil 2005;86:1214-20.Objective: To determine the net moments on the glenohumeral joint and elbow joint during wheelchair activities.Design: Kinematics and external forces were measured during wheelchair activities of daily living (level propulsion, riding on a slope, weight-relief lifting, reaching, negotiating a curb) and processed in an inverse dynamics biomechanic model.Setting: Biomechanics laboratory. Participants: Five able-bodied subjects, 8 subjects with paraplegia, and 4 subjects with tetraplegia.Interventions: Not applicable. Main Outcome Measure: Net moments on the glenohumeral joint and elbow joint.Results: Peak shoulder and elbow moments were significantly higher for negotiating a curb and weight-relief lifting than for reaching, level propulsion, and riding on a slope. Overall, the elbow extension moments were significantly lower for subjects with tetraplegia than for those with paraplegia.Conclusions: The net moments during weight-relief lifting and negotiating a curb were high when compared with wheelchair propulsion tasks. Taking the effect of frequency and duration into account, these loads might imply a considerable risk for joint damage in the long term.Key Words: Activities of daily living; Biomechanics; Elbow; Rehabilitation; Shoulder; Wheelchairs. © 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and RehabilitationI N HANDRIM WHEELCHAIR USERS, the upper extremities are at serious risk of overuse injuries. Wheelchair use requires continuous use of the upper extremities, not only for mobility but also for transfers, weight-relief lifts, and reaching activities. Studies 1,2 have shown that shoulder pain and impingement frequently occur among people with a spinal cord injury (SCI). Pain is experienced during wheelchair-related activities of daily living (ADLs), such as wheelchair propulsion and performing transfers. Because these activities are essential for functional independence, quality of life, and even the life expectancy of people after an SCI, 3 evaluating the mechanical load on the shoulder is important to an understanding of the mechanisms that may cause upper-extremity joint degeneration. Factors that have been mentioned as contributors to the development of shoulder complaints are the relatively high load and high frequency of this load on the shoulder during wheelchair propulsion. 4 In addition, and possibly even more important, the load on the shoulder during other wheelchairrelated tasks, such as transfers and weight-relief lifts, has been mentioned. [5][6][7] In our study, we used net moments around the elbow and the glenohumeral joint (GHJ) to quantify the mechanical load on those joints. Net joint moments are generally used to analyze (working) conditions and to classify these conditions. 8 To show the high loading at the shoulder, studies 9-12 have ...

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Section: Methodsmentioning

confidence: 99%

Mechanical Load on the Upper Extremity During Wheelchair Activities

Drongelen

Woude

Janssen

et al. 2005

Archives of Physical Medicine and Rehabilitation

144

110

View full text Add to dashboard Cite

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“…However, activities such as transferring and wheeling do require activation of major muscle groups and as a result can be very strenuous. 9,10 The increased strain accompanying these ADL may deter participation and consequently limit opportunities for community integration. However, it has been demonstrated that increased fitness reduces the strain of ADL.…”

Section: Introductionmentioning

confidence: 99%

“…However, it has been demonstrated that increased fitness reduces the strain of ADL. 9 Accordingly, increasing fitness may allow individuals with SCI to complete strenuous ADL (for example, mobility activities) with less difficulty and for prolonged periods. Moreover, with increased fitness individuals may become more proficient at performing passive ADL (for example, personal care activities) and require less time to complete this type of activity.…”

Section: Introductionmentioning

confidence: 99%

Activities of daily living performed by individuals with SCI: relationships with physical fitness and leisure time physical activity

2008

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Study Design: Cross-sectional. Objectives: To examine patterns of participation in activities of daily living (ADL) and fitness-related factors associated with these patterns among individuals with spinal cord injury (SCI). Setting: Centre for Health Promotion and Rehabilitation at McMaster University, School of Kinesiology and Health Studies at Queen's University. Methods: Forty-eight participants completed the Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) and a fitness test assessing cardiovascular fitness (VO 2max and peak power output (Po)). The most commonly reported ADL were extracted from the PARA-SCI data for analysis. Results: Women tended to spend more time participating in domestic and personal care ADL than men. Compared to individuals with tetraplegia, individuals with paraplegia tended to spend more time transferring, cleaning and preparing food and less time wheeling, toileting and dressing. Fitness and participation in leisure time physical activity (LTPA) were associated with certain ADL. Participants with higher levels of fitness spent more time partaking in ADL wheeling and cleaning. Moreover, greater time spent participating in moderate-and heavy-intensity LTPA was positively correlated with time spent engaged in certain ADL. Conclusion: By identifying common ADL performed by individuals with SCI, the study findings begin to provide direction for developing strategies to optimize ADL participation. Future research should examine fitness as a way to help individuals with SCI optimize their ADL participation.

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“…In persons with a spinal cord injury (SCI), HR has also been used to prescribe training intensity, 1 as well as to indicate physical strain in daily activities. [2][3][4] The guidelines of the American College of Sports Medicine (ACSM) for training of able-bodied persons -50-85% heart rate reserve (HRR) 5 -have also been applied in training studies with persons with paraplegia (PP) 6 as well as tetraplegia (TP). 7,8 These guidelines may be valid for persons with PP, as several studies [9][10][11][12][13][14] showed a strong individual linear HR-VO 2 relationship in persons with PP.…”

Section: Introductionmentioning

confidence: 99%

The individual relationship between heart rate and oxygen uptake in people with a tetraplegia during exercise

et al. 2006

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Study design: Descriptive study. Objective: To examine the individual heart rate-oxygen uptake (HR-VO 2 ) relationship during exercise in persons with tetraplegia (TP). Setting: Rehabilitation Centre Heliomare, Wijk aan Zee, The Netherlands. Methods: The HR-VO 2 relationship was determined in untrained subjects with motor complete TP (C5 or C6, n ¼ 10 and C7 or C8, n ¼ 10) during a discontinuous graded exercise hand cycle test. The mean HR and VO 2 of the final 60 s of 2-min exercise blocks were used for calculation of the individual correlation coefficient and the standard error of the estimate (SEE). Results: Two subjects of the C5-C6 group were not able to complete the test. Individual Pearson's correlation coefficients (r) ranged from 0.68 to 0.97 and SEE from 2.6 to 22.4% VO 2 -Reserve (VO 2 R). The mean Pearson's r and SEE were 0.8170.12 and 10.675.6% VO 2 R in the C5-C6 group and 0.9170.07 and 7.073.2% VO 2 R in the C7-C8 group, respectively. Two subjects of the C5-C6 group and six subjects of the C7-C8 group attained a linear HR-VO 2 relationship with an acceptable SEE (p6.0%) and r (40.90). Conclusions: The HR-VO 2 relationship appeared linear in only eight out of 18 subjects. An individual analysis of the HR-VO 2 relationship is necessary to determine whether HR can be used to quantify exercise intensity. The use of HR to prescribe training intensity should be reconsidered in persons with TP. Sponsorship: This study is supported from a grant by ZON-MW.

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Relationship between physical strain during standardised ADL tasks and physical capacity in men with spinal cord injuries

Cited by 71 publications

References 18 publications

Mechanical Load on the Upper Extremity During Wheelchair Activities

Mechanical Load on the Upper Extremity During Wheelchair Activities

Activities of daily living performed by individuals with SCI: relationships with physical fitness and leisure time physical activity

The individual relationship between heart rate and oxygen uptake in people with a tetraplegia during exercise

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