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Modifications in Wheelchair Propulsion Technique with Speed.

Russell IM, Raina S, Requejo PS, Wilcox RR, Mulroy S, McNitt-Gray JL - Front Bioeng Biotechnol (2015)

Bottom Line: Upper extremity kinematics and kinetics were compared within subject between propulsion speeds.Reorientation of the RF relative to the upper extremity segments can be used as an effective strategy for mitigating rotational demands (NJM) imposed on the shoulder at increased propulsion speeds.Identification of propulsion strategies that individuals can use to effectively accommodate for increases in RFs is an important step toward preserving musculoskeletal health of the shoulder and improving health-related quality of life.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Engineering, University of Southern California , Los Angeles, CA , USA.

ABSTRACT

Objective: Repetitive loading of the upper limb joints during manual wheelchair (WC) propulsion (WCP) has been identified as a factor that contributes to shoulder pain, leading to loss of independence and decreased quality of life. The purpose of this study was to determine how individual manual WC users with paraplegia modify propulsion mechanics to accommodate expected increases in reaction forces (RFs) generated at the pushrim with self-selected increases in WCP speed.

Methods: Upper extremity kinematics and pushrim RFs were measured for 40 experienced manual WC users with paraplegia while propelling on a stationary ergometer at self-selected free and fast propulsion speeds. Upper extremity kinematics and kinetics were compared within subject between propulsion speeds. Between group and within-subject differences were determined (α = 0.05).

Results: Increased propulsion speed was accompanied by increases in RF magnitude (22 of 40, >10 N) and shoulder net joint moment (NJM, 15 of 40, >10 Nm) and decreases in pushrim contact duration. Within-subject comparison indicated that 27% of participants modified their WCP mechanics with increases in speed by regulating RF orientation relative to the upper extremity segments.

Conclusions: Reorientation of the RF relative to the upper extremity segments can be used as an effective strategy for mitigating rotational demands (NJM) imposed on the shoulder at increased propulsion speeds. Identification of propulsion strategies that individuals can use to effectively accommodate for increases in RFs is an important step toward preserving musculoskeletal health of the shoulder and improving health-related quality of life.

No MeSH data available.


Related in: MedlinePlus

Within-subject comparison of self-selected wheelchair propulsion velocity. Black dots are velocity at free speed condition and blue squares are velocity at fast speed condition. Dotted vertical lines connect each subject’s free and fast velocities and show velocity increase. All subjects successfully increased propulsion velocity.
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Figure 2: Within-subject comparison of self-selected wheelchair propulsion velocity. Black dots are velocity at free speed condition and blue squares are velocity at fast speed condition. Dotted vertical lines connect each subject’s free and fast velocities and show velocity increase. All subjects successfully increased propulsion velocity.

Mentions: Consistent with the experimental design, all of the 40 participants significantly increased their WCP speed between free and fast conditions across all participants (p = 0.0001, Figure 2). Mean velocity across all participants during free condition was 1.02 m/s (0.3) and mean velocity across all participants during fast condition was 1.72 m/s (0.3). The velocity increase between free and fast conditions was on average 0.70 (0.2) m/s across participants.


Modifications in Wheelchair Propulsion Technique with Speed.

Russell IM, Raina S, Requejo PS, Wilcox RR, Mulroy S, McNitt-Gray JL - Front Bioeng Biotechnol (2015)

Within-subject comparison of self-selected wheelchair propulsion velocity. Black dots are velocity at free speed condition and blue squares are velocity at fast speed condition. Dotted vertical lines connect each subject’s free and fast velocities and show velocity increase. All subjects successfully increased propulsion velocity.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4620433&req=5

Figure 2: Within-subject comparison of self-selected wheelchair propulsion velocity. Black dots are velocity at free speed condition and blue squares are velocity at fast speed condition. Dotted vertical lines connect each subject’s free and fast velocities and show velocity increase. All subjects successfully increased propulsion velocity.
Mentions: Consistent with the experimental design, all of the 40 participants significantly increased their WCP speed between free and fast conditions across all participants (p = 0.0001, Figure 2). Mean velocity across all participants during free condition was 1.02 m/s (0.3) and mean velocity across all participants during fast condition was 1.72 m/s (0.3). The velocity increase between free and fast conditions was on average 0.70 (0.2) m/s across participants.

Bottom Line: Upper extremity kinematics and kinetics were compared within subject between propulsion speeds.Reorientation of the RF relative to the upper extremity segments can be used as an effective strategy for mitigating rotational demands (NJM) imposed on the shoulder at increased propulsion speeds.Identification of propulsion strategies that individuals can use to effectively accommodate for increases in RFs is an important step toward preserving musculoskeletal health of the shoulder and improving health-related quality of life.

View Article: PubMed Central - PubMed

Affiliation: Department of Biomedical Engineering, University of Southern California , Los Angeles, CA , USA.

ABSTRACT

Objective: Repetitive loading of the upper limb joints during manual wheelchair (WC) propulsion (WCP) has been identified as a factor that contributes to shoulder pain, leading to loss of independence and decreased quality of life. The purpose of this study was to determine how individual manual WC users with paraplegia modify propulsion mechanics to accommodate expected increases in reaction forces (RFs) generated at the pushrim with self-selected increases in WCP speed.

Methods: Upper extremity kinematics and pushrim RFs were measured for 40 experienced manual WC users with paraplegia while propelling on a stationary ergometer at self-selected free and fast propulsion speeds. Upper extremity kinematics and kinetics were compared within subject between propulsion speeds. Between group and within-subject differences were determined (α = 0.05).

Results: Increased propulsion speed was accompanied by increases in RF magnitude (22 of 40, >10 N) and shoulder net joint moment (NJM, 15 of 40, >10 Nm) and decreases in pushrim contact duration. Within-subject comparison indicated that 27% of participants modified their WCP mechanics with increases in speed by regulating RF orientation relative to the upper extremity segments.

Conclusions: Reorientation of the RF relative to the upper extremity segments can be used as an effective strategy for mitigating rotational demands (NJM) imposed on the shoulder at increased propulsion speeds. Identification of propulsion strategies that individuals can use to effectively accommodate for increases in RFs is an important step toward preserving musculoskeletal health of the shoulder and improving health-related quality of life.

No MeSH data available.


Related in: MedlinePlus