The effects of rear-wheel camber on the kinematics of upper extremity during wheelchair propulsion

Abstract

BackgroundThe rear-wheel camber, defined as the inclination of the rear wheels, is usually used in wheelchair sports, but it is becoming increasingly employed in daily propulsion. Although the rear-wheel camber can increase stability, it alters physiological performance during propulsion. The purpose of the study is to investigate the effects of rear-wheel cambers on temporal-spatial parameters, joint angles, and propulsion patterns.MethodsTwelve inexperienced subjects (22.3±1.6 yr) participated in the study. None had musculoskeletal disorders in their upper extremities. An eight-camera motion capture system was used to collect the three-dimensional trajectory data of markers attached to the wheelchair-user system during propulsion. All participants propelled the same wheelchair, which had an instrumented wheel with cambers of 0°, 9°, and 15°, respectively, at an average velocity of 1 m/s.ResultsThe results show that the rear-wheel camber significantly affects the average acceleration, maximum end angle, trunk movement, elbow joint movement, wrist joint movement, and propulsion pattern. The effects are especially significant between 0° and 15°. For a 15° camber, the average acceleration and joint peak angles significantly increased (p < 0.01). A single loop pattern (SLOP) was adopted by most of the subjects.ConclusionsThe rear-wheel camber affects propulsion patterns and joint range of motion. When choosing a wheelchair with camber adjustment, the increase of joint movements and the base of support should be taken into consideration.

Aspects of Manual Wheelchair Configuration Affecting Mobility: A Review

“…Camber angles wider than 15° increase the elbow ROM, reduce wrist radial deviation and increase wrist ulnar deviation15 ) . The changes in wrist kinematics are a consequence of the contact and release positions of the handrim happening in a more forward position.…”

“…Many studies have investigated how different wheelchair configurations impact the biomechanics of manual propulsion. Seat angle and dimensions, rear wheels’ vertical and horizontal position, and wheel size and camber have been shown to affect propulsion efficiency and wheelchair drivability 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 ) . In an effort to preserve upper limb function among wheelchair users, the Paralyzed Veterans of America Consortium of Spinal Cord Medicine 23 ) provided some guidelines for prescribing and adjusting a wheelchair in order to reduce the risk of developing injuries in to the upper extremities.…”

How Was Studied the Effect of Manual Wheelchair Configuration on Propulsion Biomechanics: A Systematic Review on Methodologies

“…Methods: Three studies investigated the effect of camber angle through overground experiments, involving novice AB subjects ( 38 , 39 ), or highly trained MWC basketball and tennis athletes ( 52 ). As one article is sports oriented and the others focus on daily life displacements, the range of studied camber angles varied noticeably between studies: from 15° to 24° ( 52 ), and from 0° to 15° ( 38 , 39 ). On average, 3 different camber angles (minimum 2, maximum 4) were tested per study.…”

Review Paper: Wheelchair Design and Its Influence on Physical Activity and Quality of Life Among Disabled Individuals

“…A variety of design modifications have been suggested to reduce the impact of repetitive tension on the upper limbs. Important, biomechanically studied modifications include use of different configurations for hand rim [44,56], rear wheel angle and inclination [57] and seat position [58]. The additive effects of daily activities, repetitive strains and dose-response relationships in developing overuse injuries are issues of ongoing research [43, 59].…”