Analyse critique des matériels et des méthodes d’évaluation de l’aptitude physique chez le blessé médullaire en fauteuil roulant

Unmatched speed perceptions between overground and treadmill manual wheelchair propulsion in long-term manual wheelchair users

BACKGROUND

Manual wheelchair (MWC) propulsion is increasingly assessed on a motorized treadmill (TM), which is often considered more ecologically valid than stationary rollers. However, no clear consensus on the similarities between overground (OG) and TM propulsion has yet been reached. Furthermore, no study has investigated the participants' perceptions of propelling a MWC on a TM compared to OG.

RESEARCH QUESTION

The present study aims to assess the perception of speed when propelling on a TM vs OG, and to relate this perception to measured spatiotemporal variables, kinetics and work.

METHODS

In this repeated-measures study, the propulsion's spatiotemporal variables, kinetics, and work of nineteen experienced wheelchair users with a spinal cord injury were compared between three conditions: 1) OG at a self-selected speed, 2) on a TM at a self-selected speed perceived as being similar to the OG speed (TM_perceived), and 3) on a TM at the same speed as OG (TM_matched). Each variable was compared between conditions using an analysis of variance for repeated measures.

RESULTS

All participants selected a lower speed for TM_perceived than OG, with a difference of -0.6 m/s (-44%). This adaptation may be due to a combination of two factors: 1) the absence of speed information, and 2) the feeling of urgency to grab the wheels during the recovery phase. The power output, work per cycle, and work per minute were also much lower on TM_perceived than OG. However, in contrast to other work on MWC propulsion on a TM, the kinetic variables assessed were all similar between the OG and TM_matched conditions.

SIGNIFICANCE

Training on a TM should be performed at a speed that matches the OG speed and not at a self-selected speed on the TM, which would reduce the power output and work and therefore reduce the efficiency of the training.