Identifying key experience-related differences in over-ground manual wheelchair propulsion biomechanics

Journal of Rehabilitation and Assistive Technologies Engineering, 2016 · DOI: 10.1177/2055668316678362 · Published: January 1, 2016

Spinal Cord Injury Assistive Technology Biomedical

Simple Explanation

This study aimed to compare manual wheelchair propulsion techniques between experienced wheelchair users and novices during various over-ground tasks. The study measured push rim kinetics, trunk and upper limb kinematics, and shoulder muscle activity levels to understand the differences. The researchers hypothesized that expert users would complete tasks with fewer pushes while maintaining a higher average velocity.

Study Duration

Not specified

Participants

7 experts (SCI T5-L1) and 6 novices

Evidence Level

Not specified

Key Findings

1
Experts required fewer pushes on level and cross-slope tasks, applying similar push rim moment over a greater push arc with lower muscle activity.
2
During incline tasks, experts maintained greater average velocity and generated greater power using a similar push rim moment over a greater push arc with greater angular velocity.
3
Experts showed greater trunk flexion and higher shoulder muscle activity during incline propulsion.

Research Summary

The study investigates the differences in manual wheelchair propulsion techniques between expert and novice users during over-ground tasks, focusing on kinetics, kinematics, and muscle activity. Expert users demonstrated more efficient techniques, particularly on inclines, by generating greater power and maintaining higher velocities with fewer pushes. The findings highlight the complex interplay between propulsion technique, muscle activity, and the risk of upper limb injury in manual wheelchair users.

Practical Implications

Optimizing Propulsion Technique

The study provides insights into efficient propulsion techniques that can be taught to novice wheelchair users to reduce strain and improve mobility.

Informing Real-Time Feedback Systems

The findings can be used to develop real-time feedback systems that help wheelchair users improve their propulsion technique and reduce the risk of injury.

Developing Targeted Training Programs

The study highlights the importance of considering both repetition and muscle force requirements when designing training programs for manual wheelchair users.

Study Limitations

1
Small sample size limits the generalizability of the findings.
2
The expert group only included paraplegic participants with SCI below T1, limiting applicability to tetraplegic subjects.
3
The study only measured propulsion biomechanics on the left side, potentially missing asymmetry in propulsion technique.

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