Reliability Of Upper Extremity Kinematics During Adaptive Rowing In Manual Wheelchair Users

No comprehensive biomechanical study has documented upper extremity (U/E) kinematics and kinetics during the performance of wheelchair wheelies among manual wheelchair users (MWUs). The aim of this study was to describe movement strategies (kinematics), mechanical loads (kinetics), and power at the nondominant U/E joints during a wheelie among MWUs with spinal cord injury (SCI). During a laboratory assessment, 16 MWUs with SCI completed four wheelie trials on a rigid surface. Each participant’s wheelchair was equipped with instrumented wheels to record handrim kinetics, while U/E and wheelchair kinematics were recorded with a 3D motion analysis system. The greatest mean and peak total net joint moments were generated by the shoulder flexors (mean = 7.2 ± 3.5 N·m; peak = 20.7 ± 12.9 N·m) and internal rotators (mean = 3.8 ± 2.2 N·m; peak = 11.4 ± 10.9 N·m) as well as by the elbow flexors (mean = 5.5 ± 2.5 N·m; peak = 14.1 ± 7.6 N·m) during the performance of wheelies. Shoulder flexor and internal rotator efforts predominantly generate the effort needed to lift the front wheels of the wheelchair, whereas the elbow flexor muscles control these shoulder efforts to reach a state of balance. In combination with a task-specific training program that remains essential to properly learn how to control wheelies among MWUs with SCI, rehabilitation professionals should also propose a shoulder flexor, internal rotator, and elbow flexor strengthening program.

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Validation of an Instrumented Wheelchair Hand Rim

2017 Design of Medical Devices Conference ◽

10.1115/dmd2017-3499 ◽

2017 ◽

Cited By ~ 1

Author(s):

Alan Gaglio ◽

Scott Daigle ◽

Elizabeth Gacek ◽

Omid Jahanian ◽

Brooke Slavens ◽

...

Keyword(s):

Upper Extremity ◽

Joint Pain ◽

Planetary Gear ◽

The United States ◽

Gear Ratio ◽

Gear Train ◽

Wheelchair Propulsion ◽

Wheelchair Users ◽

Manual Wheelchair ◽

High Incidence

An estimated 3.26 million manual wheelchair users (MWUs) exist in the United States [1]. MWUs report a high incidence of upper extremity joint pain largely attributed to wheelchair propulsion, which exposes the upper limbs to high forces and torques repetitively over time [2]. There exists a clear need for assistive wheelchair technologies capable of reducing the loads experienced by the upper extremity joints during propulsion. IntelliWheels, Inc. has developed multi-geared wheel systems, including both low and high gear systems, where a planetary gear train connects the wheel hub to the wheel hand rim. Decreasing gear ratio, we hypothesize, may reduce the forces and torques required by the user during propulsion. To evaluate this claim, we constructed and validated an instrumented wheelchair hand rim system capable of use on either geared or standard wheelchair wheels. Commercially available devices exist to perform wheelchair kinetics, such as the SmartWheel (SW) (Three River Holdings LLC; Mesa, AZ, USA), however, these devices require the use of a manufacturer specified wheel. As a result, a custom solution was required to interface with the geared wheels used in this study.

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Calibration and Evaluation of a Force Measurement Glove for Field-Based Monitoring of Manual Wheelchair Users

2020 IEEE 20th International Conference on Bioinformatics and Bioengineering (BIBE) ◽

10.1109/bibe50027.2020.00170 ◽

2020 ◽

Author(s):

Anthony Anderson ◽

Alexander W. Hooke ◽

Chandrasekaran Jayaraman ◽

Adam Burns ◽

Emma Fortune ◽

...

Keyword(s):

Force Measurement ◽

Wheelchair Users ◽

Manual Wheelchair

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Pain and its impact on functioning and disability in manual wheelchair users with spinal cord injury: a protocol for a mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2020-044152 ◽

2021 ◽

Vol 11 (1) ◽

pp. e044152

Author(s):

Mokgadi Kholofelo Mashola ◽

Elzette Korkie ◽

Diphale Joyce Mothabeng

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

South African ◽

Phase 1 ◽

Pain Medication ◽

Self Management ◽

Medication Misuse ◽

Wheelchair Users ◽

Manual Wheelchair ◽

Cord Injury

IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).Ethics and disseminationApproval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.

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