Biomechanics and physiology in active manual wheelchair propulsion

Woude, L.H.V. van der; Veeger, H.E.J.; Dallmeijer, Annet J.; Janssen, Thomas W J; Rozendaal, L.A.

doi:10.1016/s1350-4533(01)00083-2

Cited by 213 publications

(206 citation statements)

References 88 publications

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“…3 Others have designed ergometers on which the patient is placed. 4 Considering that wheelchair propulsion on a treadmill is mechanically realistic, 5 despite not reproducing air resistance, it is interesting that the treadmill has been used mainly for physiological studies 6 rather than to examine joint kinetics. The ergometer and rollers position the wheelchair so that all spatial movements except wheel rotation are disabled.…”

Section: Introductionmentioning

confidence: 99%

“…Some authors consider that wheelchair propulsion on a treadmill is the situation that most closely simulates real-life propulsion on a smooth surface. 6,7 Given the lack of similar studies, we undertook this study to analyze shoulder kinetics while propelling a wheelchair placed on a treadmill and to compare shoulder joint net forces and moments when changing the speed of wheelchair propulsion on the treadmill. We hypothesized that 1.…”

Section: Introductionmentioning

confidence: 99%

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Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients

et al. 2009

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Study design: Prospective study using biomechanics patient data. Objectives: To analyze shoulder joint kinetics while propelling a wheelchair placed on a treadmill and compare shoulder joint net forces and moments when changing the speed of wheelchair propulsion on the treadmill. Setting: National Hospital for Spinal Cord Injury, Toledo, Spain. Methods: Sixteen subjects with thoracic spinal cord injury participated. A kinematic analysis system consisting of four camcorders (Kinescan-IBV) and a kinetic device that registered the contact force of the hand on the pushrim (SMART Wheel ) were used. The wheelchair was propelled at 3 and 4 km h À1 without any ramp. An inverse dynamic model allowed shoulder joint net forces and moments to be calculated from the contact force of the hand on the pushrim and kinematic data. Results: Increasing propulsion speed increased most of the temporal parameters of propulsion and pushrim kinetics and shoulder joint net forces and moments. Compared with other studies that used an ergometer or dynamometer at the same speed, the magnitude of the shoulder joint net forces and moments elicited by wheelchair propulsion on the treadmill were lower than obtained by wheelchair propulsion on other devices. Conclusion: Lower magnitude of shoulder joint forces and moments found on the treadmill may be due to the lower friction compared with the other devices reviewed. Shoulder joint forces and moments depended strongly on the propulsion speed, increasing in magnitude when speed increased from 3 to 4 km h À1 .

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients

et al. 2009

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“…In spite of the large number of users worldwide, locomotion with manual wheelchairs is associated with upper-extremity injuries, shoulder pain, large energy demand and low efficiency [1][2][3]. The inefficiency of wheelchair locomotion has been linked to the radial component of the push force during the propulsion phase [4,5], based on the fact that only the tangential component of the force on the rim contributes to the moment applied to wheel and, therefore, to actual wheelchair propulsion.…”

Section: Introductionmentioning

confidence: 99%

A Modeling Framework to Investigate the Radial Component of the Pushrim Force in Manual Wheelchair Propulsion

Ackermann

Costa

Leonardi

2015

MATEC Web of Conferences

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Abstract.The ratio of tangential to total pushrim force, the so-called Fraction Effective Force (FEF), has been used to evaluate wheelchair propulsion efficiency based on the fact that only the tangential component of the force on the pushrim contributes to actual wheelchair propulsion. Experimental studies, however, consistently show low FEF values and recent experimental as well as modelling investigations have conclusively shown that a more tangential pushrim force direction can lead to a decrease and not increase in propulsion efficiency. This study aims at quantifying the contributions of active, inertial and gravitational forces to the normal pushrim component. In order to achieve this goal, an inverse dynamics-based framework is proposed to estimate individual contributions to the pushrim forces using a model of the wheelchair-user system. The results show that the radial pushrim force component arise to a great extent due to purely mechanical effects, including inertial and gravitational forces. These results corroborate previous findings according to which radial pushrim force components are not necessarily a result of inefficient propulsion strategies or hand-rim friction requirements. This study proposes a novel framework to quantify the individual contributions of active, inertial and gravitational forces to pushrim forces during wheelchair propulsion.

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“…1-3 However, manual wheelchair propulsion is considered to be a strenuous activity in terms of expended energy and demanded biomechanics. 4 Consequently, the assessment of energy cost during wheelchair propulsion is an important outcome during rehabilitation programs for patients with SCI, as it allows for an objective evaluation of physical fitness, in addition to determining the clinical effectiveness of important interventions, such as adaptations and an appropriate choice of wheelchair, as well as physical training.…”

Section: Introductionmentioning

confidence: 99%

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

2014

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Study design: Cross-sectional study. Objectives: To validate heart rate (HR) indexes for the evaluation of energy expenditure during wheelchair propulsion in people with spinal cord injury (SCI). Setting: SARAH Rehabilitation Hospital Network-Brasilia, Brazil. Methods: Forty-eight men aged 29.0 ± 7.8 years with a SCI between C6 and L3 causing complete motor impairment were enrolled in the study. The assessment consisted of 5 min of rest while seated in the wheelchair, followed by 5 min of wheelchair propulsion at a self-selected comfortable speed. The main outcomes measured were oxygen consumption, HR, physiological cost index (PCI), total heart beat index (THBI) and propulsion cardiac cost index (PCCI). Results: Using oxygen uptake as gold standard, the highest correlations were found between this and PCCI (r ¼ 0.59, Po0.001, 95% confidence interval (CI) 0.36-0.75) and THBI (r ¼ 0.58, Po0.001, 95% CI 0.36-74.0), independently of the injury level. The PCI had the lowest correlation coefficient (r ¼ 0.38, Po0.01, 95% CI 0.11-0.60). Spearman correlation analysis showed that the indexes mostly associated with lesion level were PCCI (r ¼ À0.531; Po0.001; 95% CI À0.708 to À0.291) and THBI (r ¼ À0.524; Po0.001; 95% CI À0.704 to À0.282). Conclusions: Both THBI and PCCI seem to be valid measures for assessing energy expenditure. Both indexes showed a coherent correlation with the spinal injury level.

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Biomechanics and physiology in active manual wheelchair propulsion

Cited by 213 publications

References 88 publications

Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients

Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients

A Modeling Framework to Investigate the Radial Component of the Pushrim Force in Manual Wheelchair Propulsion

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

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