The Effect of Visual Biofeedback on the Propulsion Effectiveness of Experienced Wheelchair Users

Kotajarvi, Brian R.; Basford, Jeffrey R.; An, Kai Nan; Morrow, Duane A.; Kaufman, Kenton R.

doi:10.1016/j.apmr.2005.12.033

Cited by 45 publications

(45 citation statements)

References 27 publications

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“…1,5,13,14 Our kinetic results stand out from other related works because subjects unexpectedly modified their propulsion biomechanics favorably from early to late in a 10-minute trial without technique coaching or feedback training. 12,15 Our subjects displayed a steady cadence, increased time on the pushrim and reductions in both rate of rise of force and Fz (inward directional force), all at a steady state velocity. However, it is evident that the three subjects who dropped out and not included in the analysis of the fourth time point may have skewed the results slightly.…”

Section: Discussionmentioning

confidence: 82%

Manual wheelchair stroke characteristics during an extended period of propulsion

et al. 2008

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Methods: Kinetic data were recorded from 21 subjects with paraplegia at four time points over the course of a 10-min propulsion trial at a steady state speed of 1.4 m s À1 . Upper extremity kinetic parameters were recorded using Smartwheels, force and torque sensing pushrims. Results: Subjects for propulsion biomechanics changed from early to late during the 10-min trial. Individuals displayed decreased maximum rate of rise of resultant force (P ¼ 0.0045) with a simultaneous increase in push time (P ¼ 0.043) and stroke time (P ¼ 0.023), whereas stroke frequency remained static. In addition, there was a decrease in out of plane moment application (P ¼ 0.032). Conclusion: Individuals seemed to naturally accommodate their propulsive stroke, using less injurious propulsion biomechanics over the course of a 10-minute trial on a dynamometer. The findings may have occurred as a result of both biomechanical compensations to a challenging propulsion trial and accommodation to propelling on a dynamometer. These results suggest that subjects may be capable of independently incorporating favorable biomechanical strategies to meet the demands of a challenging propulsion scenario.

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Section: Discussionmentioning

confidence: 82%

Manual wheelchair stroke characteristics during an extended period of propulsion

et al. 2008

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“…Direct force feedback like FEF was eliminated as a training variable because the literature indicates that it does not always relate to ME consistently and can cause radical and unsafe alteration of their propulsion technique (23). In addition, it is evident that propulsion on a dynamometer does not always translate to over ground where an individual must incorporate chair handling skills and use visual and environmental cues during propulsion.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, a decision was made to not use force feedback because our training program was submaximal and FEF tends to increase with higher work loads. It has also been suggested that increasing FEF may cause subjects to push with a higher percentage of force tangential to the pushrim, which could lead to unintended changes in biomechanics (20,21,23). Hence, the goal of this training program was to use cadence and push angle feedback to encourage subjects to take longer, less frequent strokes and to decrease force exerted at a given velocity, without causing unintended changes in force direction.…”

Section: Variable Selectionmentioning

confidence: 99%

“…de Groot et al (20,22) presented able-bodied subjects with real-time velocity and fraction of effective force (FEF) feedback and found trained subjects to exhibit higher FEF accompanied by significantly lower mechanical efficiency (20,22). Kotajarvi et al (23) presented FEF, velocity, and power output feedback to experienced wheelchair users and again found no improvements in force effectiveness, but did observe increased contact angle and decreased stroke frequency. FEF is the proportion of force at the hand rim that contributes to forward motion defined as Ft/F, where Ft is the tangential force obtained by dividing the measured wheel torque by the radius of the pushrim, and F is the resultant force.…”

Section: Introductionmentioning

confidence: 99%

“…Few recent studies have explored methods in which to improve manual wheelchair propulsion biomechanics (19)(20)(21)(22)(23)(24). Two studies have proposed programs focusing primarily on upper limb strength training (24,25), whereas others have investigated simulated manual wheelchair propulsion training protocols completed on stationary ergometers at low intensities and durations with no feedback or with only visual velocity feedback (22,26,27).…”

Section: Introductionmentioning

confidence: 99%

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Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

Rice

Gagnon

Gallagher

et al. 2010

The Journal of Spinal Cord Medicine

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Background/Objective: As considerable progress has been made in laboratory-based assessment of manual wheelchair propulsion biomechanics, the necessity to translate this knowledge into new clinical tools and treatment programs becomes imperative. The objective of this study was to describe the development of a manual wheelchair propulsion training program aimed to promote the development of an efficient propulsion technique among long-term manual wheelchair users. Methods: Motor learning theory principles were applied to the design of biomechanical feedback-based learning software, which allows for random discontinuous real-time visual presentation of key spatiotemporal and kinetic parameters. This software was used to train a long-term wheelchair user on a dynamometer during 3 low-intensity wheelchair propulsion training sessions over a 3-week period. Biomechanical measures were recorded with a SmartWheel during over ground propulsion on a 50-m level tile surface at baseline and 3 months after baseline. Results: Training software was refined and administered to a participant who was able to improve his propulsion technique by increasing contact angle while simultaneously reducing stroke cadence, mean resultant force, peak and mean moment out of plane, and peak rate of rise of force applied to the pushrim after training. Conclusions:The proposed propulsion training protocol may lead to favorable changes in manual wheelchair propulsion technique. These changes could limit or prevent upper limb injuries among manual wheelchair users. In addition, many of the motor learning theory-based techniques examined in this study could be applied to training individuals in various stages of rehabilitation to optimize propulsion early on.

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Relationship Between Resultant Force at the Pushrim and the Net Shoulder Joint Moments During Manual Wheelchair Propulsion in Elderly Persons

Desroches

Aïssaoui

Bourbonnais

2008

Archives of Physical Medicine and Rehabilitation

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The Effect of Visual Biofeedback on the Propulsion Effectiveness of Experienced Wheelchair Users

Cited by 45 publications

References 27 publications

Manual wheelchair stroke characteristics during an extended period of propulsion

Manual wheelchair stroke characteristics during an extended period of propulsion

Hand Rim Wheelchair Propulsion Training Using Biomechanical Real-Time Visual Feedback Based on Motor Learning Theory Principles

Relationship Between Resultant Force at the Pushrim and the Net Shoulder Joint Moments During Manual Wheelchair Propulsion in Elderly Persons

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