The influence of speed and grade on wheelchair propulsion hand pattern

Slowik, Jonathan S.; Requejo, Philip S.; Mulroy, Sara J.; Neptune, Richard R.

doi:10.1016/j.clinbiomech.2015.07.007

Cited by 23 publications

(17 citation statements)

References 21 publications

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“…The mean spatial-temporal wheelchair propulsion parameters observed in this investigation were consistent with previous literature (Boninger et al, 1997, Shimada et al, 1998, Boninger et al, 2002, Collinger et al, 2008, Richter et al, 2011, Raina, S et al, 2012, Slowik, J.S et al, 2015). This benchmarking was essential to suggest that the observations from our investigation are generalizable and qualitative comparison of our results with previous literature is acceptable.…”

Section: Discussionsupporting

confidence: 92%

Shoulder pain and jerk during recovery phase of manual wheelchair propulsion

Jayaraman

Beck

Sosnoff

2015

Journal of Biomechanics

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Repetitive loading of the upper limb due to wheelchair propulsion plays a leading role in the development of shoulder pain in manual wheelchair users (mWCUs). There has been minimal inquiry on understanding wheelchair propulsion kinematics from a human movement ergonomics perspective. This investigation employs an ergonomic metric, jerk, to characterize the recovery phase kinematics of two recommended manual wheelchair propulsion patterns: semi-circular and the double loop. Further it examines if jerk is related to shoulder pain in mWCUs. Data from 22 experienced adult mWCUs was analyzed for this study (semi-circular: n=12 (pain/without-pain:6/6); double-loop: n=10 (pain/without-pain:4/6)). Participants propelled their own wheelchair fitted with SMARTWheels on a roller dynamometer at 1.1 m/s for 3 minutes. Kinematic and kinetic data of the upper limbs were recorded. Three dimensional absolute jerk experienced at the shoulder, elbow and wrist joint during the recovery phase of wheelchair propulsion were computed. Two-way ANOVAs were conducted with the recovery pattern type and shoulder pain as between group factors. Findings (1) Individuals using a semi-circular pattern experienced lower jerk at their arm joints than those using a double loop pattern (P<0.05, η2=0.32)wrist; (P=0.05, η2=0.19)elbow; (P<0.05, η2=0.34)shoulder and (2) individuals with shoulder pain had lower peak jerk magnitude during the recovery phase (P≤0.05, η2=0.36)wrist; (P≤0.05, η2=0.30)elbow; (P≤0.05, η2=0.31)shoulder. Conclusions Jerk during wheelchair propulsion was able to distinguish between pattern types (semi-circular and double loop) and the presence of shoulder pain. Jerk provides novel insights into wheelchair propulsion kinematics and in the future it may be beneficial to incorporate jerk based metric into rehabilitation practice.

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Section: Discussionsupporting

confidence: 92%

Shoulder pain and jerk during recovery phase of manual wheelchair propulsion

Jayaraman

Beck

Sosnoff

2015

Journal of Biomechanics

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“…1). Hand patterns were characterized using a set of objective, quantitative parameters (see Slowik et al, 2015 for details), and this characterization was used to identify four groups of subjects that used each of the four hand pattern types. From these groups, twenty male subjects (five of each hand pattern type) were then identified such that differences between pattern-type group averages for age, time from injury, height, mass, body mass index and propulsion speed were minimized (Table 1).…”

Section: Methodsmentioning

confidence: 99%

The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress

Slowik

Requejo

Mulroy

et al. 2016

Journal of Biomechanics

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The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground.

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“…In general, encountering a bump at 1 km/h (slow speed) allowed the user to safely stop without tipping. On level ground, comfortable propulsion speeds range from 3.7 km/h [25] to 4.6 km/h [26], with downhill wheeling sometimes faster. For terrain with bumps these speeds may become unsafe, thus for controlled wheeling the user may be required to slow down.…”

Section: Discussionmentioning

confidence: 99%

Manual wheelchair downhill stability: an analysis of factors affecting tip probability

Thomas

Borisoff

Sparrey

2018

J NeuroEngineering Rehabil

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BackgroundFor people who use manual wheelchairs, tips and falls can result in serious injuries including bone fractures, concussions, and traumatic brain injury. We aimed to characterize how wheelchair configuration changes (including on-the-fly adjustments), user variables, and usage conditions affected dynamic tip probability while rolling down a slope and contacting a small block.MethodsRigid body dynamic models of a manual wheelchair and test dummy were created using multi-body software (Madymo, TASS International, Livonia, MI), and validated with 189 experiments. Dynamic stability was assessed for a range of seat angles (0 to 20° below horizontal), backrest angles (0 to 20°), rear axle positions (0 to 20 cm from base of backrest), ground slopes (0 to 15°), bump heights (0 to 4 cm), wheelchair speeds (0 to 20 km/hr), user masses (50 to 115 kg), and user positions (0 to 10 cm from base of backrest). The tip classifications (forward tip, backward tip, rolled over bump, or stopped by bump) were investigated using a nominal logistic regression analysis.ResultsFaster wheelchair speeds significantly increased the probability of tipping either forward or backward rather than stopping, but also increased the probability of rolling over the bump (p < 0.001). When the rear axle was positioned forward, this increased the risk of a backward tip compared to all other outcomes (p < 0.001), but also reduced the probability of being stopped by the bump (p < 0.001 compared to forward tip, p < 0.02 compared to rolling over). Reclining the backrest reduced the probability of a forward tip compared to all other outcomes (p < 0.001), and lowering the seat increased the probability of either rolling over the bump or tipping backwards rather than tipping forward (p < 0.001). In general, the wheelchair rolled over bumps < 1.5 cm, and forwards tipping was avoided by reducing the speed to 1 km/hr.ConclusionsThe probability of forward tipping, corresponding to the greatest risk of injury, was significantly reduced for decreased speeds, smaller bumps, a reclined backrest, and a lower rear seat height. For wheelchairs with dynamic seating adjustability, when travelling downhill, on-the-fly adjustments to the seat or backrest can increase the likelihood of safely rolling over a bump.

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The influence of speed and grade on wheelchair propulsion hand pattern

Cited by 23 publications

References 21 publications

Shoulder pain and jerk during recovery phase of manual wheelchair propulsion

Shoulder pain and jerk during recovery phase of manual wheelchair propulsion

The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress

Manual wheelchair downhill stability: an analysis of factors affecting tip probability

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