Kinematics and pushrim kinetics in adolescents propelling high-strength lightweight and ultra-lightweight manual wheelchairs

Abstract

Compared with the standard lightweight wheelchair, ultra-lightweight wheelchair propulsion was associated with lower pushrim forces, lower energy costs, higher self-selected speeds, and increased shoulder and elbow flexion. These variables have been linked to injury risk and mobility efficiency, and the results provided evidence that differences in weight and configuration options are both contributors. Findings can inform decision-making in the prescription of manual wheelchairs for pre-adult populations. Implications for Rehabilitation A significant proportion of manual wheelchair users are children and adolescents, and due to the early onset of use they may be especially predisposed to the development of chronic overuse injuries. The study reports differences in energy costs, pushrim forces, and upper body kinematics measured when adolescents propelled standard and ultra-lightweight wheelchairs across three trial conditions. In the ultra-lightweight wheelchair, reduced energy cost is linked to more efficient mobility, and lower forces may be linked to lower risk of chronic injury. Significant differences in elbow and shoulder kinematics are also reported, and the findings support the importance of both weight and setup options in the selection of manual wheelchairs.

Manual wheelchair biomechanics while overcoming various environmental barriers: A systematic review

“…On the contrary, results on trunk inclination are in agreement between studies with an increase of trunk flexion-extension RoM with the grade [ 29 , 44 , 50 ]. An increase of the neck extension with the grade, consistent with the increase of the trunk extension to keep the gaze orientation, was also observed [ 44 ]. Wrist flexion-extension and radio-ulnar deviation RoM also tended to increase [ 53 ], as well as elbow flexion-extension and pronation-supination RoM [ 49 ].…”

“…Important differences can be noted between studies in all degrees of freedom (DoF) of the glenohumeral joint. In particular, the evolution of the glenohumeral flexion-extension range of motion (RoM) with the grade differed with either an increase [ 29 ], no observed change [ 44 , 48 , 50 ], or even a decrease for AB users in one study [ 50 ]. On the contrary, results on trunk inclination are in agreement between studies with an increase of trunk flexion-extension RoM with the grade [ 29 , 44 , 50 ].…”

“…In particular, the evolution of the glenohumeral flexion-extension range of motion (RoM) with the grade differed with either an increase [ 29 ], no observed change [ 44 , 48 , 50 ], or even a decrease for AB users in one study [ 50 ]. On the contrary, results on trunk inclination are in agreement between studies with an increase of trunk flexion-extension RoM with the grade [ 29 , 44 , 50 ]. An increase of the neck extension with the grade, consistent with the increase of the trunk extension to keep the gaze orientation, was also observed [ 44 ].…”

“…Twelve studies investigated the influence of various ground types on MWC propulsion [ 15 , 25 – 27 , 31 , 32 , 34 , 35 , 38 , 39 , 43 , 44 ] ( Table 5 ). The experiments were conducted on MWU populations ranging from eight to 128 participants (M: 31, SD: 36), among which most were SCI participants.…”

“…Kinematics were recorded using an opto-electronic motion capture system [ 35 ] or inertial measurement units [ 44 ]. Kinetics were recorded using instrumented wheels mounted on both sides of the MWC [ 15 , 26 , 27 , 31 , 32 , 35 ] or one side only [ 25 , 34 , 44 ]. It was not reported if a dummy wheel was also mounted when only one instrumented wheel was used.…”