Movement strategies during car transfers in individuals with tetraplegia: a preliminary study

Abstract

Study design: Three-dimensional kinematic analysis of car transfer (CT) movement in four adult males with C6 tetraplegia. Objectives: The aim of the present study was to assess the normal transfer technique movement from a wheelchair to a car (that is, CT) in subjects with tetraplegia. A better understanding of CT movement is invaluable knowledge for spinal cord injury rehabilitation. This type of knowledge will improve rehabilitation programs so that patients with tetraplegia will have greater societal participation. Setting: School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan. Methods: Four adult males with C6 tetraplegia, an impairment grade of A according to the American Spinal Injury Association guidelines, took part in the study. The subjects used their own wheelchair and car in our assessments of their CT movement technique. Movements were assessed using a three-dimensional video analysis system with six digital video cameras. CT data, which included lateral displacement of the head and buttocks, and angular displacement of neck flexion and trunk forward inclination, were collected and correlation coefficients were calculated.Results: All four subjects demonstrated negative correlations in lateral displacements greater than 0.70. As for correlation coefficients of angular displacement, two subjects demonstrated negative correlations (r¼À0.98 and r¼À0.77) and one subject demonstrated a positive correlation (r¼0.75). The neck flexion and trunk forward inclination strategy was different among the four subjects. Conclusions: Each subject with C6 tetraplegia demonstrated different strategies during CT movement.

Relationship between the duration and trunk inclination and hip angle during car transfer in individuals with tetraplegia

“…Previous studies showed that coordinated flexion movement between the head and trunk assist the buttocks to lift off the seat6,7,8 ) . Additionally, the strategy of neck flexion and forward inclination of the trunk was found to differ among subjects with C6 tetraplegia during CT movement5 ) .…”

“…Among these activities, the CT movement to the driver’s seat is particularly important because it is related to other transfer movements in daily living. Kinematic analysis of the CT movement in individuals with C6 tetraplegia showed that these individuals prefer the rotatory movement pattern in which their head moves in the opposite direction to their buttocks5 ) . In an analysis of the CT movement in individuals with tetraplegia, the subjects confirmed that they could move their buttocks by inclining their trunk forward inclination by via neck control, because of trunk muscle paralysis5 ) .…”

“…Kinematic analysis of the CT movement in individuals with C6 tetraplegia showed that these individuals prefer the rotatory movement pattern in which their head moves in the opposite direction to their buttocks5 ) . In an analysis of the CT movement in individuals with tetraplegia, the subjects confirmed that they could move their buttocks by inclining their trunk forward inclination by via neck control, because of trunk muscle paralysis5 ) . However, this previous study only analyzed the head, trunk, and buttocks during CT movement in individuals with tetraplegia, and it did not examine the position of the lower limbs whereby individuals with C6 tetraplegia could control their paralyzed trunks.…”

The wheelchair and its essential components for the mobility of quadriplegic persons with spinal cord injury

“…It should also provide a more active life and social participation that will result in an improved quality of life. 9,[18][19][20] Quadriplegic individuals, those with impaired trunk control, need higher backs on their wheelchairs when compared to those who have more trunk control. According to Cherubini & Melchiorri, 21 the back should be positioned 20mm below the lower angle of the scapula, in order to guarantee greater stability to its user.…”

Effect of technique and transfer board use on the performance of wheelchair transfers

“…Wheelchair users are a very diverse population that encompass individuals of different sex, age and medical conditions but, more importantly, different functional abilities and lifestyles [4]. Most studies on wheelchair transfers focus mainly on the analysis of sitting pivot transfers performed by individuals with spinal cord injury (SCI) [5–8]. Although individuals with SCI represent a significant group within the wheelchair users’ population, they are not representative of the full population.…”