A theoretical analysis of the influence of wheelchair seat position on upper extremity demand

Slowik, Jonathan S.; Neptune, Richard R.

doi:10.1016/j.clinbiomech.2013.03.004

Cited by 24 publications

(8 citation statements)

References 74 publications

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“…The dynamic equations-of-motion were generated using SD/FAST (Parametric Technology Corp., Needham, MA, USA). The major upper extremity muscles crossing the shoulder and elbow joints were represented by 26 Hill-type musculotendon actuators (see Slowik and Neptune, 2013) and governed by intrinsic muscle force-length-velocity and tendon force-strain relationships. Each actuator received a distinct excitation signal except the three latissimus dorsi actuators, the two sternocostal pectoralis major actuators, and the two actuators representing the lateral triceps and anconeus.…”

Section: Methodsmentioning

confidence: 99%

The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress

Slowik

Requejo

Mulroy

et al. 2016

Journal of Biomechanics

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The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground.

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Section: Methodsmentioning

confidence: 99%

The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress

Slowik

Requejo

Mulroy

et al. 2016

Journal of Biomechanics

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View full text Add to dashboard Cite

show abstract

“…The dynamic equations-of-motion were generated using SD/FAST (Parametric Technology Corp., Needham, MA, USA). Twenty-six Hill-type musculoskeletal actuators, governed by intrinsic muscle force-length-velocity and tendon force-strain relationships, represented the major upper extremity muscles crossing the shoulder and elbow joints (e.g., Slowik and Neptune, 2013). Each actuator received a distinct excitation signal except the two sternocostal pectoralis major actuators, the three latissimus dorsi actuators, and the two actuators representing the lateral triceps and anconeus.…”

Section: Methodsmentioning

confidence: 99%

Compensatory strategies during manual wheelchair propulsion in response to weakness in individual muscle groups: A simulation study

Slowik

McNitt-Gray

Requejo

et al. 2016

Clinical Biomechanics

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Background The considerable physical demand placed on the upper extremity during manual wheelchair propulsion is distributed among the individual muscles. The strategy used to distribute the workload is likely influenced by the relative force-generating capacities of individual muscles, and some strategies may be associated with a higher injury risk than others. The objective of this study was to use forward dynamics simulations of manual wheelchair propulsion to identify compensatory strategies that can be used to overcome weakness in individual muscle groups and identify specific strategies that may increase injury risk. Identifying these strategies can provide rationale for the design of targeted rehabilitation programs aimed at preventing the development of pain and injury in manual wheelchair users. Methods Muscle-actuated forward dynamics simulations of manual wheelchair propulsion were analyzed to identify compensatory strategies in response to individual muscle group weakness, using individual muscle mechanical power and stress as measures of upper extremity demand. Findings The simulation analyses found the upper extremity to be robust to weakness in any single muscle group as the remaining groups were able to compensate and restore normal propulsion mechanics. The rotator cuff muscles experienced relatively high muscle stress levels and exhibited compensatory relationships with the deltoid muscles. Interpretation These results underline the importance of strengthening the rotator cuff muscles and supporting muscles whose contributions do not increase the potential for impingement (i.e., the thoracohumeral depressors) and minimize the risk of upper extremity injury in manual wheelchair users.

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“…Experiments were conducted on novice AB subjects. Two tire types (pneumatic and solid) and four pneumatic tire pressure conditions [100,75,50, and 25% of the recommended pressure (i.e., 6 bars in that case)] were evaluated. A configuration with extra mass (5 and 10 kg) added on the rear wheel axle was examined both for 100% pressure pneumatic tires and for solid tires.…”

Section: Tire Type and Pressurementioning

confidence: 99%

How Was Studied the Effect of Manual Wheelchair Configuration on Propulsion Biomechanics: A Systematic Review on Methodologies

Fritsch

Poulet

Bascou

et al. 2022

Front. Rehabilit. Sci.

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BackgroundFor both sports and everyday use, finding the optimal manual wheelchair (MWC) configuration can improve a user's propulsion biomechanics. Many studies have already investigated the effect of changes in MWC configuration but comparing their results is challenging due to the differences in experimental methodologies between articles.PurposeThe present systematic review aims at offering an in-depth analysis of the methodologies used to study the impact of MWC configuration on propulsion biomechanics, and ultimately providing the community with recommendations for future research.MethodsThe reviewing process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart on two databases (Scopus and PubMed) in March 2022.ResultsForty-five articles were included, and the results highlighted the multiplicity of methodologies regarding different experimental aspects, including propulsion environment, experimental task, or measurement systems, for example. More importantly, descriptions of MWC configurations and their modifications differed significantly between studies and led to a lack of critical information in many cases.DiscussionStudying the effect of MWC configuration on propulsion requires recommendations that must be clarified: (1) the formalism chosen to describe MWC configuration (absolute or relative) should be consistent with the type of study conducted and should be documented enough to allow for switching to the other formalism; (2) the tested MWC characteristics and initial configuration, allowing the reproduction or comparison in future studies, should be properly reported; (3) the bias induced by the experimental situation on the measured data must be considered when drawing conclusions and therefore experimental conditions such as propulsion speed or the effect of the instrumentation should be reported.ConclusionOverall, future studies will need standardization to be able to follow the listed recommendations, both to describe MWC configuration and mechanical properties in a clear way and to choose the experimental conditions best suited to their objectives.

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A theoretical analysis of the influence of wheelchair seat position on upper extremity demand

Cited by 24 publications

References 74 publications

The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress

The influence of wheelchair propulsion hand pattern on upper extremity muscle power and stress

Compensatory strategies during manual wheelchair propulsion in response to weakness in individual muscle groups: A simulation study

How Was Studied the Effect of Manual Wheelchair Configuration on Propulsion Biomechanics: A Systematic Review on Methodologies

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