Effects of Motor Skill-Based Training on Wheelchair Propulsion Biomechanics in Older Adults: A Randomized Controlled Trial

Exercise Guidelines to Counteract Physical Deconditioning in Long-Term Care Facilities: What to Do and How to Do It?

With age, older adults experience a decrease in muscle function and changes in body composition, which raise the risk of functional incapacity and loss of autonomy. These declines are more pronounced in older adults living in long-term care (LTC) facilities than those living in the community (ie, sarcopenia prevalence: ∼41% vs ∼10%; obesity prevalence: 30% vs17%). The main cause of these declines is chronic diseases, which are a driver of higher rates of sedentary behavior (85% of time in LTC). Exercise, however, is recognized to help counteract age-related decline, yet it is not integrated into clinical practice.

Effect of wheelchair configurations on shoulder movements, push rim kinetics and upper limb kinematics while negotiating a speed bump

This study aimed to provide a comprehensive assessment of upper limb kinetics and kinematics and shoulder movements during wheelchair propulsion while negotiating a speed bump of 6 cm height using four different wheelchair configurations. 16 healthy males aged 30.8 ± 5.7 years participated in the experiment. The kinetic and kinematic data during wheelchair propulsion were recorded. A smart system was used to collect the push forces and a motion capture system was used to collect upper limb movements. The results show that approximately 50% more pushing force was required to negotiate the speed bump than that of level ground propulsion. At the upward-forward axle position, peak total forces were 95.17 ± 5.70 N which resulted in significantly improved propulsion ergonomics, but 129.36 ± 6.68 N was required at the upward-back axle position at the speed bump push. The findings could help manufactures to design protective gloves for wheelchair users and provide useful rehabilitation information to clinicians and patients. Practitioner summary: This study investigated pushing forces and movements during wheelchair propulsion over a speed bump. Approximately 50% more pushing force was required to negotiate the bump than a level surface propulsion. The upper-forward axle position was found to be reasonably better than other positions during wheelchair propulsion. Abbreviations: UF: upper and forward position; UB: upper and back position; DF: down and forward position; DB: down and back position; ROM: range of motion.