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Evaluation of pediatric manual wheelchair mobility using advanced biomechanical methods.

Slavens BA, Schnorenberg AJ, Aurit CM, Graf A, Krzak JJ, Reiners K, Vogel LC, Harris GF - Biomed Res Int (2015)

Bottom Line: Upper extremity joint kinematics, forces, and moments were computed using inverse dynamics methods with our custom model.The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension.These evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training.

View Article: PubMed Central - PubMed

Affiliation: Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA ; Rehabilitation Research Design and Disability (R 2 D 2 ) Center, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA ; Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA.

ABSTRACT
There is minimal research of upper extremity joint dynamics during pediatric wheelchair mobility despite the large number of children using manual wheelchairs. Special concern arises with the pediatric population, particularly in regard to the longer duration of wheelchair use, joint integrity, participation and community integration, and transitional care into adulthood. This study seeks to provide evaluation methods for characterizing the biomechanics of wheelchair use by children with spinal cord injury (SCI). Twelve subjects with SCI underwent motion analysis while they propelled their wheelchair at a self-selected speed and propulsion pattern. Upper extremity joint kinematics, forces, and moments were computed using inverse dynamics methods with our custom model. The glenohumeral joint displayed the largest average range of motion (ROM) at 47.1° in the sagittal plane and the largest average superiorly and anteriorly directed joint forces of 6.1% BW and 6.5% BW, respectively. The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension. Pediatric manual wheelchair users demonstrating these high joint demands may be at risk for pain and upper limb injuries. These evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training.

No MeSH data available.


Related in: MedlinePlus

Group average joint force data of the dominant side wrist, elbow, and glenohumeral joints. Mean (bold) and +/− one standard deviation joint forces of the wrist joint: top row, elbow joint: middle row, and the glenohumeral (GH) joint: bottom row of the subjects' dominant side.
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Related In: Results  -  Collection


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fig6: Group average joint force data of the dominant side wrist, elbow, and glenohumeral joints. Mean (bold) and +/− one standard deviation joint forces of the wrist joint: top row, elbow joint: middle row, and the glenohumeral (GH) joint: bottom row of the subjects' dominant side.

Mentions: Group mean joint forces and moments of the glenohumeral, elbow, and wrist joints were characterized over the wheelchair stroke cycle. The group's mean joint forces (+/− one standard deviation) along each axis are depicted in Figure 6. The mean group joint moments (+/− one standard deviation) in each plane of motion are depicted in Figure 7.


Evaluation of pediatric manual wheelchair mobility using advanced biomechanical methods.

Slavens BA, Schnorenberg AJ, Aurit CM, Graf A, Krzak JJ, Reiners K, Vogel LC, Harris GF - Biomed Res Int (2015)

Group average joint force data of the dominant side wrist, elbow, and glenohumeral joints. Mean (bold) and +/− one standard deviation joint forces of the wrist joint: top row, elbow joint: middle row, and the glenohumeral (GH) joint: bottom row of the subjects' dominant side.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352734&req=5

fig6: Group average joint force data of the dominant side wrist, elbow, and glenohumeral joints. Mean (bold) and +/− one standard deviation joint forces of the wrist joint: top row, elbow joint: middle row, and the glenohumeral (GH) joint: bottom row of the subjects' dominant side.
Mentions: Group mean joint forces and moments of the glenohumeral, elbow, and wrist joints were characterized over the wheelchair stroke cycle. The group's mean joint forces (+/− one standard deviation) along each axis are depicted in Figure 6. The mean group joint moments (+/− one standard deviation) in each plane of motion are depicted in Figure 7.

Bottom Line: Upper extremity joint kinematics, forces, and moments were computed using inverse dynamics methods with our custom model.The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension.These evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training.

View Article: PubMed Central - PubMed

Affiliation: Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA ; Rehabilitation Research Design and Disability (R 2 D 2 ) Center, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA ; Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA.

ABSTRACT
There is minimal research of upper extremity joint dynamics during pediatric wheelchair mobility despite the large number of children using manual wheelchairs. Special concern arises with the pediatric population, particularly in regard to the longer duration of wheelchair use, joint integrity, participation and community integration, and transitional care into adulthood. This study seeks to provide evaluation methods for characterizing the biomechanics of wheelchair use by children with spinal cord injury (SCI). Twelve subjects with SCI underwent motion analysis while they propelled their wheelchair at a self-selected speed and propulsion pattern. Upper extremity joint kinematics, forces, and moments were computed using inverse dynamics methods with our custom model. The glenohumeral joint displayed the largest average range of motion (ROM) at 47.1° in the sagittal plane and the largest average superiorly and anteriorly directed joint forces of 6.1% BW and 6.5% BW, respectively. The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension. Pediatric manual wheelchair users demonstrating these high joint demands may be at risk for pain and upper limb injuries. These evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training.

No MeSH data available.


Related in: MedlinePlus