Using a mobility assistance dog reduces upper limb effort during manual wheelchair ramp ascent in an individual with spinal cord injury

Impacts of Mobility Dogs on Kinematics during Ambulation: A Quantitative Study

While prior research has explored various physiological consequences associated with assistive device use for ambulation, limited research has specifically explored the impact of mobility dog partnership on human kinematics. This descriptive study examined the impact of mobility dog partnership on kinematics of individuals in the normal young adult population. Sixteen participants were video recorded while walking in a straight line for 3.7 m (12 feet) under three different conditions (ambulating with no device, ambulating with a standard cane on the left side, and ambulating with a mobility dog on the left side). Differences between joint angles under each of the conditions were analyzed. Statistically significant differences were found in left elbow flexion when comparing ambulating with a cane versus ambulating with no device; left shoulder abduction when comparing ambulating with a cane versus ambulating with a mobility dog, ambulating with a mobility dog versus no device, and ambulating with a cane versus no device; and left hip extension when comparing ambulating with a mobility dog versus no device, and when ambulating with a mobility dog versus a cane. These findings suggest that providers should evaluate and monitor potential negative impacts of assistive devices such as mobility dogs on human kinematics.

Effects of a trained mobility assistance dog on upper extremity muscular effort during wheelchair propulsion on tiled and carpeted floors in individuals with a spinal cord injury

BACKGROUND

Many manual wheelchair users with a spinal cord injury are at risk of developing secondary upper extremity musculoskeletal impairments. The use of a mobility assistance dog may represent a way to mitigate this risk. This study aims to compare upper extremity muscular effort in this population when propelling a manual wheelchair on tiled and carpeted surfaces with and without the assistance of a dog.

METHOD

Thirteen adults with a spinal cord injury propelled their manual wheelchairs at a self-selected natural speed over a 10-meter distance on tiled abrasive and carpeted floors with and without their mobility assistance dog. Surface electromyography of the pectoralis major, anterior deltoid, biceps, and triceps was recorded and normalized against its maximal value extracted from maximal voluntary contractions. Time needed to perform each task was also computed.

FINDINGS

The forward pull provided by the dog significantly and meaningfully reduced the muscular effort when propelling on the tiled floor and, even more so, on carpeted surfaces for the pectoralis major (-27.0% and -59.2%), the anterior deltoid (-54.8% and -92.4%), the biceps (-53.9% and -57.6%), and the triceps (-45.7% and -67.3%). The time needed to travel the 10-meter distance was also significantly and meaningfully reduced on the tiled and carpeted surfaces (-21.9% and -30.3%, respectively).

INTERPRETATION

The provision of a mobility assistance dog represents a viable rehabilitation alternative to minimizing upper extremity muscular effort while also optimizing speed during propulsion in manual wheelchair users with a spinal cord injury.

Pain, fatigue, function and participation among long-term manual wheelchair users partnered with a mobility service dog

PURPOSE

To assess the effects of a mobility service dog (MSD) on pain, fatigue, wheelchair-related functional tasks, participation and satisfaction among manual wheelchair users over a nine-month period.

METHOD

A longitudinal study with repeated assessment times before and three, six and nine months after intervention was achieved. Intervention consisted in partnering each participant with a MSD. The setting is a well-established provincial service dog training school and participants homes. A convenience sample of 24 long-term manual wheelchair users with a spinal cord injury was involved. Outcome measures were: Wheelchair User's Shoulder Pain Index (WUSPI), Rate of Perceived Exertion (RPE), vitality scale from the SF-36, grip strength, Wheelchair Skills Test (WST), Canadian Occupational Performance Measure (COPM), Reintegration to Normal Living Index (RNLI), Life Space Assessment, Psychosocial Impact of Assistive Devices Scale (PIADS) and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0).

RESULTS

Shoulder and wrist pain as well as fatigue decreased significantly over time with the use of a MSD as evidenced by scores from WUSPI, RPE and SF-36 (feeling less worn out). Manual wheelchair propulsion skills (steep slopes, soft surfaces and thresholds) improved significantly over time as confirmed by the WST. Participation increased significantly over time as revealed by the COPM (for five occupations) and the RNLI (for five items). Satisfaction with the MSD was high over time (QUEST: nine items) and with a high positive psychosocial impact (PIADS: 10 items).

CONCLUSION

MSD represents a valuable mobility assistive technology option for manual wheelchair users. IMPLICATIONS FOR REHABILITATION   For manual wheelchair users partenered with mobility service dog  • Shoulder pain and fatigue significantly decreased and continued to decrease between the third and sixth month and the ninth month.   • Performance with propelling the wheelchair up steep slopes increased from 41 to 88% and on soft surfaces increased from 53 to 100% after 3 months, respectively.   • Occupational performance satisfaction was significantly increased for mobility in relation with the transfers, navigating in a natural environment and picking up objects.   • High satisfaction towards psychosocial competency, psychosocial adequacy and self-esteem were reported at months three, six and nine.