Biomechanic Evaluation of Upper-Extremity Symmetry Manual Wheelchair Propulsion Over Varied Terrain

Arch Phys Med Rehabil, 2008 · DOI: 10.1016/j.apmr.2008.03.020 · Published: October 1, 2008

Assistive Technology Rehabilitation Biomechanics

Simple Explanation

This study looks at how symmetrical the use of both arms is during wheelchair propulsion across different surfaces. The study found that upper body use is not symmetrical while propelling a wheelchair, and this asymmetry is more pronounced in outdoor settings compared to lab settings. Researchers should consider that wheelchair propulsion is an asymmetrical activity and this may influence the data collected.

Study Duration

Not specified

Participants

12 manual wheelchair users

Evidence Level

Case series

Key Findings

1
Upper-extremity asymmetry was present within each condition.
2
Outdoor community wheelchair propulsion asymmetry was significantly greater than asymmetry measured during laboratory conditions.
3
There were no differences in the magnitude of asymmetry when comparing laboratory with indoor community conditions.

Research Summary

This study has shown that manual wheelchair users with no pain or upper-extremity injury exhibit asymmetry during propulsion, with the magnitude of asymmetry impacted by the wheeling environment. The magnitude of propulsion asymmetry was significantly different during outdoor tasks compared with laboratory tasks. The greater asymmetry identified during outdoor versus laboratory conditions emphasizes the need to evaluate wheelchair biomechanics in the user’s natural environment.

Practical Implications

Clinical Implications

Understanding the asymmetrical nature of wheelchair propulsion can aid in the rehabilitation of injured manual wheelchair users.

Research Implications

Researchers should be aware of variable side-to-side difference during wheelchair propulsion, which may influence interpretation when data are collected from a single limb or averaged for both limbs.

Environmental Considerations

The study emphasizes the importance of evaluating wheelchair biomechanics in the user’s natural environment, as laboratory conditions may not accurately reflect real-world asymmetry.

Study Limitations

1
The investigation included a relatively small sample size.
2
Our cohort included subjects with variable level spinal cord lesions, and 1 subject with spina bifida.
3
The distance of each task was not constant.

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