Changes in neuromuscular activation, heart rate and rate of perceived exertion over the course of a wheelchair propulsion fatigue protocol

Frontiers in Physiology, 2023 · DOI: 10.3389/fphys.2023.1220969 · Published: October 18, 2023

Spinal Cord Injury Assistive Technology Musculoskeletal Medicine

Simple Explanation

This study aimed to understand how performance and perceived fatigue progress during wheelchair use and their relationship. The study used a figure-8 course to mimic real-world wheelchair propulsion, measuring muscle activity, heart rate, and perceived exertion. The findings showed significant increases in heart rate, perceived exertion, and activity in specific shoulder muscles during the fatigue protocol.

Study Duration

Not specified

Participants

50 participants with paraplegic spinal cord injury

Evidence Level

Not specified

Key Findings

1
Heart rate and perceived exertion significantly increased during the wheelchair propulsion fatigue protocol.
2
The activity of the trapezius and pectoralis major muscles increased significantly during the protocol, suggesting these muscles are highly impacted by fatigue during wheelchair propulsion.
3
The greatest changes in muscle activity were observed during the first 4 minutes of the fatigue protocol.

Research Summary

This study investigated changes in performance and perceived fatigability during a wheelchair propulsion fatigue protocol (F8F) in individuals with paraplegia. The results showed significant increases in heart rate, rate of perceived exertion, and activity of specific shoulder muscles (trapezius and pectoralis major) throughout the protocol. The findings provide insights into the mechanisms of fatigability and highlight the importance of exercise programs targeting scapular stabilizers.

Practical Implications

Exercise programs for scapular stabilization

The study highlights the importance of strengthening scapular stabilizers to reduce fatigability and prevent shoulder pain in wheelchair users.

Sport-specific training

Further examination of fatiguing propulsion in sport-specific settings is crucial to understand the risk of shoulder problems in wheelchair sports.

Development of fatigue protocols

Development of fatigue protocols that include daily life or sport specific activities to gain further knowledge about the inﬂuence of fatigue on the development of shoulder pain in people with SCI

Study Limitations

1
The figure-8 fatigue protocol, while mimicking real-world propulsion, lacks the variation in length, slope, velocity, and terrains found in daily life.
2
The participants' fatigue state at the beginning of the protocol was unclear due to the standardized procedures prior to the F8F.
3
Important muscles such as M. deltoideus pars clavicularis and spinalis were not included in the study.

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