Stroke Pattern and Handrim Biomechanics for Level and Uphill Wheelchair Propulsion at Self-Selected Speeds

Richter, W. Mark; Rodriguez, Russell; Woods, Kevin R.; Axelson, Peter W.

doi:10.1016/j.apmr.2006.09.017

Cited by 85 publications

(81 citation statements)

References 18 publications

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“…In contrast to the SLOP and DLOP, the ARC and SC patternfavored by the participants with tetraplegia do not require lifting the arm above the push rim and hence may require less involvement of the shoulder abductor. The ARC pattern also keeps the hands close to the rim and avoids multiple changes in direction, a potential advantage identified by Richter et al 13 The DLOP pattern incorporates high braking and acceleration of the upper limb, as noted by Shimada et al 10 which is likely to impose a relatively high level of muscular control. Additional research with larger sample sizes of the participants with tetraplegia can explain the lack of DLOP and SLOP hand movement patterns in manual wheelchair users with tetraplegia.…”

Section: Discussionmentioning

confidence: 97%

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

Raina

McNitt-Gray

Mulroy

et al. 2012

The Journal of Spinal Cord Medicine

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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.

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Section: Discussionmentioning

confidence: 97%

“…The ARC pattern was determined to be the most preferred while propelling uphill. 13 The ARC pattern was also found to have the lowest metabolic cost.…”

mentioning

confidence: 99%

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

Raina

McNitt-Gray

Mulroy

et al. 2012

The Journal of Spinal Cord Medicine

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show abstract

“…Laboratory investigations have revealed shoulder joint forces and moments (5,18), and muscle demands (24) are greater during inclined versus level propulsion. Wheelchair users also change their stroke patterns based on surface inclination angle (22). Yet laboratory conditions are limited to ergometer and level tile terrain, and are constrained in their ability to manipulate rolling resistance, propulsion distance, and the inertial effects of propulsion.…”

Section: Discussionmentioning

confidence: 99%

Wheelchair propulsion demands during outdoor community ambulation

Hurd

Morrow

Kaufman

et al. 2009

Journal of Electromyography and Kinesiology

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Objective-Quantify manual wheelchair propulsion effort during outdoor community ambulation. Design-Case seriesSubjects-Thirteen individuals (12 with SCI, 1 with spina bifida) who were experienced manual wheelchair users and had no current upper extremity injury or pain complaints.Methods-Measurements were obtained from instrumented wheelchair rims during steady-state propulsion as subjects traversed outdoor concrete sidewalk terrain that included smooth level, aggregate level, and a ramp with a smooth surface. Propulsion effort was assessed using the average propulsion moment, average instantaneous power, and work for both upper extremities.Results-Propulsion effort, captured by the propulsion moment, work and power, varied across ground conditions (p<0.001). Propulsion effort was greater as the rolling resistance increased (ie., smooth versus aggregate surfaces) and as the inclination angle progressed from level to inclined surfaces. There were no side-to-side differences across ground conditions for the propulsion moment or work. Power generation was significantly greater on the dominant compared to the non-dominant extremity during the more challenging aggregate surface and ramp conditions. Conclusions-Propulsion effort varies with demands imposed by different ground conditions. Quantification of wheelchair propulsion demands provides rehabilitations specialists with objective information to guide treatment of patients adapting to manual wheelchair use.

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“…Some authors consider that wheelchair propulsion on a treadmill is the situation that most closely simulates real-life propulsion on a smooth surface. 6,7 Given the lack of similar studies, we undertook this study to analyze shoulder kinetics while propelling a wheelchair placed on a treadmill and to compare shoulder joint net forces and moments when changing the speed of wheelchair propulsion on the treadmill. We hypothesized that 1.…”

Section: Introductionmentioning

confidence: 99%

Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients

et al. 2009

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Study design: Prospective study using biomechanics patient data. Objectives: To analyze shoulder joint kinetics while propelling a wheelchair placed on a treadmill and compare shoulder joint net forces and moments when changing the speed of wheelchair propulsion on the treadmill. Setting: National Hospital for Spinal Cord Injury, Toledo, Spain. Methods: Sixteen subjects with thoracic spinal cord injury participated. A kinematic analysis system consisting of four camcorders (Kinescan-IBV) and a kinetic device that registered the contact force of the hand on the pushrim (SMART Wheel ) were used. The wheelchair was propelled at 3 and 4 km h À1 without any ramp. An inverse dynamic model allowed shoulder joint net forces and moments to be calculated from the contact force of the hand on the pushrim and kinematic data. Results: Increasing propulsion speed increased most of the temporal parameters of propulsion and pushrim kinetics and shoulder joint net forces and moments. Compared with other studies that used an ergometer or dynamometer at the same speed, the magnitude of the shoulder joint net forces and moments elicited by wheelchair propulsion on the treadmill were lower than obtained by wheelchair propulsion on other devices. Conclusion: Lower magnitude of shoulder joint forces and moments found on the treadmill may be due to the lower friction compared with the other devices reviewed. Shoulder joint forces and moments depended strongly on the propulsion speed, increasing in magnitude when speed increased from 3 to 4 km h À1 .

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Stroke Pattern and Handrim Biomechanics for Level and Uphill Wheelchair Propulsion at Self-Selected Speeds

Cited by 85 publications

References 18 publications

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

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

Wheelchair propulsion demands during outdoor community ambulation

Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients

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