Start-up propulsion biomechanics changes with fatiguing activity in persons with spinal cord injury

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2019.1582603 · Published: July 1, 2020

Spinal Cord Injury Assistive Technology Biomechanics

Simple Explanation

This study looks at how fatigue affects the way wheelchair users start moving. The research found that after a fatiguing activity, wheelchair users applied less force when starting to move. Also, they had shorter contact times with the wheels during the initial push, which could indicate less efficient propulsion.

Study Duration

Not specified

Participants

26 wheelchair users with spinal cord injury

Evidence Level

Quasi-experimental one-group pretest-posttest design

Key Findings

1
Significant reduction in maximum resultant force at the end of the fatiguing protocol.
2
Mean velocity was significantly reduced in the second, third and fourth strokes of start-up propulsion.
3
A significantly reduced mean contact time during the first stroke of start-up propulsion was found.

Research Summary

The study investigated changes in start-up propulsion biomechanics with fatiguing wheelchair propulsion in individuals with spinal cord injury. Results showed a reduction in applied forces and contact time during start-up after the fatiguing protocol. The changes in propulsion biomechanics with fatigue may have implications for wheelchair skills training programs.

Practical Implications

Wheelchair Skills Training

Maintaining optimal propulsion mechanics with fatigue may play a role in preserving mobility.

Personalized Wheelchair Adjustments

Besides strengthening the capacity of the wheelchair user and adjusting the wheelchair to the user, the ability to maintain optimal propulsion mechanics with fatigue may play a role in preserving mobility.

Targeted Interventions

Findings support intervention programs aiming at maintaining efficient start-up propulsion biomechanics in persons with SCI.

Study Limitations

1
This study did not include objective measures to investigate the mechanisms of fatigue.
2
The protocol has not been validated to induce fatigue.
3
Due to a lack of measures of pathology, we do not know if the changes are adaptive and prevent injury, nor if they promote injury development.

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