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Rietveld T, Vegter RJK, van der Woude LHV, de Groot S. A newly developed hand rim for wheelchair tennis improves propulsion technique and efficiency in able-bodied novices. APPLIED ERGONOMICS 2022; 104:103830. [PMID: 35751939 DOI: 10.1016/j.apergo.2022.103830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
A new wheelchair tennis hand rim was developed, having a larger contact area and higher friction. How does this new hand rim compare to a regular hand rim regarding submaximal propulsion with a tennis racket during practice in novices? Twenty-four able-bodied novices (12 Regular Rim, 12 New Rim) completed a one-day experiment: pre-test, three practice-sessions and a post-test of 3 × 4 min each on a wheelchair ergometer (1.11 m/s, 7W). The New Rim group compared to the Regular Rim group, had a lower negative work per cycle (-0.83J vs. -2.06J, p = 0.01) at the post-test. There was a significantly larger increase in mechanical efficiency between the pre- and post-test in the New Rim group (2.3-3.4% vs. 2.1-2.5%, p = 0.02) compared to the Regular Rim group. The new rim led to a more ergonomic propulsion technique, with a reduction in negative power and higher mechanical efficiency between the pre- and post-test at submaximal propulsion.
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Affiliation(s)
- Thomas Rietveld
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands.
| | - Riemer J K Vegter
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands; Loughborough University, Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough, United Kingdom
| | - Lucas H V van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, the Netherlands; Loughborough University, Peter Harrison Centre for Disability Sport, School of Sport, Exercise & Health Sciences, Loughborough, United Kingdom; University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands; Vrije Universiteit Amsterdam, Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, the Netherlands
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2
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A novel push-pull central-lever mechanism reduces peak forces and energy-cost compared to hand-rim wheelchair propulsion during a controlled lab-based experiment. J Neuroeng Rehabil 2022; 19:30. [PMID: 35300710 PMCID: PMC8932120 DOI: 10.1186/s12984-022-01007-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/02/2022] [Indexed: 11/21/2022] Open
Abstract
Background Hand-rim wheelchair propulsion is straining and mechanically inefficient, often leading to upper limb complaints. Previous push–pull lever propulsion mechanisms have shown to perform better or equal in efficiency and physiological strain. Propulsion biomechanics have not been evaluated thus far. A novel push–pull central-lever propulsion mechanism is compared to conventional hand-rim wheelchair propulsion, using both physiological and biomechanical outcomes under low-intensity steady-state conditions on a motor driven treadmill. Methods In this 5 day (distributed over a maximum of 21 days) between-group experiment, 30 able-bodied novices performed 60 min (5 × 3 × 4 min) of practice in either the push–pull central lever wheelchair (n = 15) or the hand-rim wheelchair (n = 15). At the first and final sessions cardiopulmonary strain, propulsion kinematics and force production were determined in both instrumented propulsion mechanisms. Repeated measures ANOVA evaluated between (propulsion mechanism type), within (over practice) and interaction effects. Results Over practice, both groups significantly improved on all outcome measures. After practice the peak forces during the push and pull phase of lever propulsion were considerably lower compared to those in the handrim push phase (42 ± 10 & 46 ± 10 vs 63 ± 21N). Concomitantly, energy expenditure was found to be lower as well (263 ± 45 vs 298 ± 59W), on the other hand gross mechanical efficiency (6.4 ± 1.5 vs 5.9 ± 1.3%), heart-rate (97 ± 10 vs 98 ± 10 bpm) and perceived exertion (9 ± 2 vs 10 ± 1) were not significantly different between modes. Conclusion The current study shows the potential benefits of the newly designed push–pull central-lever propulsion mechanism over regular hand rim wheelchair propulsion. The much lower forces and energy expenditure might help to reduce the strain on the upper extremities and thus prevent the development of overuse injury. This proof of concept in a controlled laboratory experiment warrants continued experimental research in wheelchair-users during daily life.
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de Klerk R, van der Jagt G, Veeger D, van der Woude L, Vegter R. Learning of Wheelchair Racing Propulsion Skills Over Three Weeks of Wheeling Practice on an Instrumented Ergometer in Able-Bodied Novices. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:777085. [PMID: 36188930 PMCID: PMC9397947 DOI: 10.3389/fresc.2022.777085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022]
Abstract
The acquisition of daily handrim wheelchair propulsion skill as a multi-layered phenomenon has been studied in the past. Wheelchair racing, however, is considerably different from daily handrim wheelchair propulsion in terms of propulsion technique, as well as the underlying equipment and interface. Understanding wheelchair racing skill acquisition is important from a general motor learning and skill acquisition perspective, but also from a performance and injury prevention perspective. The aim of the current lab-based study was 2-fold: to investigate the evolution of racing wheelchair propulsion skill among a sample of novices and to compare them with an experienced wheelchair racer under similar conditions. A convenience sample of 15 able-bodied novices (8 male, 7 female) completed a standardized three-week submaximal uninstructed practice protocol (3 weeks, 3 sessions per week, 3x4 min per session) in a racing wheelchair on an ergometer. Required wheeling velocity was set at 2.78 m/s (10 km/h) and a rolling friction coefficient of 0.011 (resulting in a mean target load of 21W) was used. For comparison, an experienced T54 Paralympic athlete completed one block of the same protocol. Kinetics, kinematics, and physiological data were captured. A mixed effects regression analysis was used to examine the effect of practice for the novices, while controlling for speed. All participants finished the protocol successfully. However, not all participants were able to achieve the target speed during the first few sessions. Statistically significant improvements over time were found for all outcome measures (i.e., lower metabolic strain, longer push and cycle times) with the exception of mean power and torque per push. The athlete used a significantly greater contact angle and showed “better” outcomes on most metabolic and kinetic variables. While the athlete used a semi-circular propulsion technique, most participants used a double looping over technique. Three weeks of uninstructed wheelchair racing practice significantly improved efficiency and skill among a group of novices, in line with previous studies on daily handrim wheelchair propulsion. The comparison with an experienced athlete expectedly showed that there is still a large performance (and knowledge) gap to be conquered.
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Affiliation(s)
- Rick de Klerk
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Gabriëlle van der Jagt
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Dirkjan Veeger
- Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, Netherlands
| | - Lucas van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Center for Rehabilitation, University Medical Center Groningen, Groningen, Netherlands
| | - Riemer Vegter
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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Giesbrecht E. Wheelchair Skills Test Outcomes across Multiple Wheelchair Skills Training Bootcamp Cohorts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:21. [PMID: 35010282 PMCID: PMC8750881 DOI: 10.3390/ijerph19010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
User training is a critical component of wheelchair service delivery to ensure individuals with a mobility impairment can negotiate environmental barriers and promote their social participation. A wheelchair "bootcamp", delivered during professional preparation education, is one strategy to better prepare occupational therapists for clinical rehabilitation practice by developing their own wheelchair skills. The purpose of this study was a retrospective review of a large dataset of student cohorts from a single site and delineate bootcamp effects on the Wheelchair Skills Test-Questionnaire (WST-Q) scores. Participant data from eight cohorts was consolidated (n = 307). Comparison of two WST-Q scoring formats revealed significantly lower scores for cohorts using the 4-point version, which was subsequently standardized to the other 3-point version. WST-Q change scores were similar between cohorts, and differences were more reflective of variability in skill level prior to bootcamp than post-bootcamp scores. Students were able to master most basic and intermediate level skills, while advanced skill acquisition was much more variable. This study provides more precise point estimates of wheelchair skill acquisition among occupational therapy students than previous studies. While confirming the benefits of bootcamp education, recommendations for further investigation were identified.
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Affiliation(s)
- Edward Giesbrecht
- College of Rehabilitation Sciences, University of Manitoba, R106-771 McDermot Avenue, Winnipeg, MB R3E OT6, Canada
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5
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Qi L, Guan S, Zhang L, Liu HL, Sun CK, Ferguson-Pell M. The Effect of Fatigue on Wheelchair Users' Upper Limb Muscle Coordination Patterns in Time-Frequency and Principal Component Analysis. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2096-2102. [PMID: 34633931 DOI: 10.1109/tnsre.2021.3119359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An assessment of shoulder muscle coordination patterns is important to gain insight into muscle fatigue during wheelchair propulsion. The objective of the present study was to quantify muscle coordination changes over time during fatiguing wheelchair propulsion, as the muscles go through distinct levels of fatigue, a) non-fatigued, b) transiting to fatigue and c) fatigued to exhaustion. We recorded surface electromyography (sEMG) signals of the anterior deltoid (AD), middle deltoid (MD), posterior deltoid (PD), infraspinatus (IS), upper trapezius (UT), sternal head of the pectoralis major (PM), biceps brachii (BB), and triceps brachii (TB) during a wheelchair incremental exercise test. Nine wheelchair users with a diagnosis of spina bifida or T6-T12 spinal cord injury volunteered for the study. Oxygen uptake and SmartWheel kinetic parameters were also recorded during the test. EMG signals were processed by wavelet and principal component analysis (PCA), allowing for an assessment of how wheelchair users modify their muscle coordination patterns over time. Analyses of covariance (ANCOVA) were conducted to identify the main effect of fatigue levels on muscle coordination patterns by controlling for the effect of increased workload as covariate. A significant effect of fatigue levels on the PC1 and PC3 loading scores was found after controlling for the effect of increasing workloads (with both cases). In addition, PC3 reflects the most dominant fatigue effect on muscle coordination patterns which are not affected by increased ergometer workload. PC3 indicates muscle imbalance when muscles are fully fatigued and muscle co-contraction when muscles are beginning to fatigue. We conclude that fatigue-related changes in neuromuscular activity during wheelchair propulsion contribute to muscle imbalance and reflect a strategy of stiffening the shoulder joint.
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Yan H, Archambault PS. Augmented feedback for manual wheelchair propulsion technique training in a virtual reality simulator. J Neuroeng Rehabil 2021; 18:142. [PMID: 34548085 PMCID: PMC8456569 DOI: 10.1186/s12984-021-00936-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Motor learning of appropriate manual wheelchair propulsion is critical, as incorrect technique elevates risk for upper extremity pain. Virtual reality simulators allow users to practice this complex task in a safe and realistic environment. Additionally, augmented feedback (AF) may be provided in order to optimize learning. The purpose of this study was to investigate the effects of providing AF with various delivery schedules on motor learning and transfer of this skill to over-ground propulsion. METHODS Thirty healthy young adults were randomly assigned to three groups. During a virtual reality propulsion training session, the high-frequency AF group received AF in the form of knowledge of performance throughout all propulsion training; the faded AF group received this AF in a faded schedule (high relative frequency of AF early in practice, with relative frequency of AF provision diminishing throughout practice); and the control group underwent training with no AF. Propulsion assessments were performed at baseline and 48 h after practice in both virtual and real environments to measure retention and transfer, respectively. RESULTS Compared to the control group, both feedback groups exhibited significant improvements in contact angle and push frequency in both environments after training. Small, non-significant between-group differences were also found between the high-frequency and faded feedback groups. CONCLUSION Virtual reality training is an effective learning intervention for acquisition, retention, and transfer of appropriate manual wheelchair propulsion technique when such training includes AF regarding propulsion biomechanics.
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Affiliation(s)
- Hui Yan
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
- Center of Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Philippe S. Archambault
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
- Center of Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
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The longitudinal relationship between shoulder pain and altered wheelchair propulsion biomechanics of manual wheelchair users. J Biomech 2021; 126:110626. [PMID: 34329882 DOI: 10.1016/j.jbiomech.2021.110626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to investigate the longitudinal association between within-subject changes in shoulder pain and alterations in wheelchair propulsion biomechanics in manual wheelchair users. Eighteen (age 33 ± 11 years) manual wheelchair users propelled their own daily living wheelchair at 1.11 m.s-1 for three minutes on a dual-roller ergometer during two laboratory visits (T1 and T2) between 4 and 6 months apart. Shoulder pain was assessed using the Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI). Between visits mean PC-WUSPI scores increased by 5.4 points and varied from - 13.5 to + 20.9 points. Of the eighteen participants, nine (50%) experienced increased shoulder pain, seven (39%) no change in pain, and two (11%) decreased pain. Increasing shoulder pain severity correlated with increased contact angle (r = 0.59, P = 0.010), thorax range of motion (r = 0.60, P = 0.009) and kinetic and kinematic variability. Additionally, increasing shoulder pain was associated with reductions in peak torque (r = -0.56, P = 0.016), peak glenohumeral abduction (r = -0.69, P = 0.002), peak scapular downward rotation (r = -0.68, P = 0.002), and range of motion in glenohumeral flexion/extension and scapular angles. Group comparisons revealed that these biomechanical alterations were exhibited by individuals who experienced increased shoulder pain, whereas, propulsion biomechanics of those with no change/decreased pain remained unaltered. These findings indicate that wheelchair users exhibit a protective short-term wheelchair propulsion biomechanical response to increases in shoulder pain which may temporarily help maintain functional independence.
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8
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Moradi J. Reply to the Comments on Moradi, J. (2020): Benefits of a Guided Motor Mental Performance Routine on Learning the Basketball Free Throw. Perceptual and Motor Skills, 127, 248-262. Percept Mot Skills 2020; 128:11-14. [PMID: 32954959 DOI: 10.1177/0031512520958825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jalil Moradi
- Department of Motor Behavior and Sport Psychology, Arak University, Arak, Iran
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van der Woude LHV, Houdijk HJP, Janssen TWJ, Seves B, Schelhaas R, Plaggenmarsch C, Mouton NLJ, Dekker R, van Keeken H, de Groot S, Vegter RJK. Rehabilitation: mobility, exercise & sports; a critical position stand on current and future research perspectives. Disabil Rehabil 2020; 43:3476-3491. [PMID: 32805152 DOI: 10.1080/09638288.2020.1806365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Human movement, rehabilitation, and allied sciences have embraced their ambitions within the cycle of "RehabMove" congresses over the past 30 years. This combination of disciplines and collaborations in the Netherlands has tried to provide answers to questions in the fields of rehabilitation and adapted sports, while simultaneously generating new questions and challenges. These research questions help us to further deepen our understanding of (impaired) human movement and functioning, with and without supportive technologies, and stress the importance of continued multidisciplinary (inter)national collaboration. METHODS This position stand provides answers that were conceived by the authors in a creative process underlining the preparation of the 6th RehabMove Congress. RESULTS The take-home message of the RehabMove2018 Congress is a plea for continued multidisciplinary research in the fields of rehabilitation and adapted sports. This should be aimed at more individualized notions of human functioning, practice, and training, but also of performance, improved supportive technology, and appropriate "human and technology asset management" at both individual and organization levels and over the lifespan. CONCLUSIONS With this, we anticipate to support the development of rehabilitation sciences and technology and to stimulate the use of rehabilitation notions in general health care. We also hope to help ensure a stronger embodiment of preventive and lifestyle medicine in rehabilitation practice. Indeed, general health care and rehabilitation practice require a healthy and active lifestyle management and research agenda in the context of primary, secondary, and tertiary prevention.IMPLICATIONS FOR REHABILITATIONContinued multidisciplinary (international) collaboration will stimulate the development of rehabilitation and human movement sciences.Notions from "human and technology asset management and ergonomics" are fundamental to rehabilitation practice and research.The rehabilitation concept will further merge into general health care and the quality there-off.
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Affiliation(s)
- Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Han J P Houdijk
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Research & Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Thomas W J Janssen
- Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands.,Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Research Institute MOVE, VU University, Amsterdam, The Netherlands
| | - Bregje Seves
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Reslin Schelhaas
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Corien Plaggenmarsch
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Noor L J Mouton
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Helco van Keeken
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands.,Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Research Institute MOVE, VU University, Amsterdam, The Netherlands
| | - Riemer J K Vegter
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Rice I, Jayaraman C, Pohlig RT. The short-term influence of rear wheel axle position and training on manual wheelchair propulsion technique in novice able-bodied participants during steady-state treadmill propulsion, a pilot study. Assist Technol 2020; 32:136-143. [DOI: 10.1080/10400435.2018.1504834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Ian Rice
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Chandrasekaran Jayaraman
- Max Näder Lab for Rehabilitation and outcomes Center for Bionic Medicine Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Ryan T. Pohlig
- Biostatistics Core Facility, College of Health Sciences, University of Delaware, Newark, DE, USA
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Leving MT, de Groot S, Woldring FAB, Tepper M, Vegter RJK, van der Woude LHV. Motor learning outcomes of handrim wheelchair propulsion during active spinal cord injury rehabilitation in comparison with experienced wheelchair users. Disabil Rehabil 2019; 43:1429-1442. [PMID: 31656102 DOI: 10.1080/09638288.2019.1668484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate changes in wheelchair propulsion technique and mechanical efficiency across first five weeks of active inpatient spinal cord injury rehabilitation and to compare the outcomes at discharge with experienced wheelchair users with spinal cord injury. METHODS Eight individuals with recent spinal cord injury performed six weekly submaximal exercise tests. The first and last measurement additionally contained a wheelchair circuit and peak graded exercise test. Fifteen experienced individuals performed all above-mentioned tests on one occasion. RESULTS Mechanical efficiency and propulsion technique did not change during the five weeks of inpatient rehabilitation. Peak power output during peak graded test and performance time on the wheelchair circuit improved between the first and the last week. No difference in propulsion technique, peak power output, and performance time was found between the persons with a recent injury and the experienced group. Mechanical efficiency was higher after the correction for the difference in relative power output in the experienced group. CONCLUSION The group with a recent injury did not improve mechanical efficiency and propulsion technique over the period of active rehabilitation, despite significant improvements on the wheelchair circuit and in work capacity. The only significant difference between the groups was found in mechanical efficiency.Implications for rehabilitationThe lack of time-dependent changes in mechanical efficiency and propulsion technique in the group with a recent spinal cord injury, combined with the lack of differences in technique, work capacity and on the wheelchair circuit between the groups, suggest that important adaptations of motor learning may happen even earlier in rehabilitation and emphasize that the group in active rehabilitation was relatively skilled.Standardized observational analyses of handrim wheelchair propulsion abilities during early spinal cord injury rehabilitation provide detailed understanding of wheelchair technique, skill as well as wheelchair propulsion capacity.Measurement of external power output is critical to interpretation of gross efficiency, propulsion technique, and capacity.Wheelchair quality and body weight - next to wheelchair fitness and skill - require careful consideration both in early rehabilitation as well as in the chronic phase of spinal cord injury.
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Affiliation(s)
- Marika T Leving
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sonja de Groot
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Amsterdam Rehabilitation Research Center
- Reade, Amsterdam, The Netherlands
| | - Ferry A B Woldring
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marga Tepper
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Riemer J K Vegter
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lucas H V van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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12
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Fallot C, Bascou J, Pillet H, Sauret C. Manual wheelchair's turning resistance: swivelling resistance parameters of front and rear wheels on different surfaces. Disabil Rehabil Assist Technol 2019; 16:324-331. [PMID: 31621434 DOI: 10.1080/17483107.2019.1675781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Daily locomotion with a manual wheelchair includes curvilinear movements. However, little is known about the resisting forces in play during turning manoeuvres where the wheels are generally both rolling and swivelling. This study aimed at quantifying the swivelling resistance parameters of several wheels on different surfaces and to evaluate the effect of the curvature radius on these parameters. MATERIALS AND METHODS A specific test bench was designed allowing the swivelling resistance parameters of a wheel rolling while swivelling to be determined. Seven wheels (3 front and 4 rear wheels), three surfaces (plywood, linoleum and carpet), two loads (25 and 45 kg) and five curvature radii (from 0 to 0.4 m) were tested through a full factorial design experiment. RESULTS Results showed that the wheel type was the most influential factor on swivelling resistance parameters, followed by the surface and the curvature radius. The effect of the load on swivelling resistance parameters was found negligible when compared to the influence of other factors. A predictive model for swivelling resistance parameters of the different wheel/surface combinations was proposed, as a function of the curvature radius. CONCLUSION This study allowed the swivelling resistance parameters of different wheel/surface combinations to be quantified, as a function of the curvature radius of the wheel trajectory. Combined with data on rolling resistance, these data could now be used to assess energy losses during real life ambulation or to achieve more realistic behaviour in virtual rehabilitation environment.Implications for rehabilitationSwivelling resistances are increased by carpet surfaces compared to tile surfaces.Conversely to rolling resistance, castors wheels are less prone to swivelling resistance than rear wheelsThe swivelling resistance of a wheel rolling while swivelling is decreased compared to a pure swivelling movement.Combined with data on rolling resistance, these data on swivelling resistance would allow energy loss during daily life activity to be determined or as input data for the control of wheelchair simulator in virtual environment used for rehabilitation.
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Affiliation(s)
- Constantin Fallot
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France.,Institution Nationale des Invalides, Centre d'Etudes et de Recherche sur l'Appareillage des Handicapés, Woippy, France
| | - Joseph Bascou
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France.,Institution Nationale des Invalides, Centre d'Etudes et de Recherche sur l'Appareillage des Handicapés, Woippy, France
| | - Hélène Pillet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
| | - Christophe Sauret
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers ParisTech, Paris, France
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Qi L, Ferguson-Pell M, Lu Y. The Effect of Manual Wheelchair Propulsion Speed on Users' Shoulder Muscle Coordination Patterns in Time-Frequency and Principal Component Analysis. IEEE Trans Neural Syst Rehabil Eng 2018; 27:60-65. [PMID: 30571642 DOI: 10.1109/tnsre.2018.2886826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A rehabilitation program for wheelchair users should be based on a thorough understanding of shoulder muscle coordination patterns. The objective of the study was to quantify the extent to which the muscle electromyographic (EMG) patterns vary with propulsion speed. A total of 11 wheelchair-dependent participants with a diagnosis of spina bifida or T6-T12 spinal cord injury volunteered for the study. Each participant performed a series of wheelchair propulsion bouts at 1m/s, 1.3 m/s, and 1.6m/s. EMG signals of 8 shoulder muscles as well as the physiological and kinetic variables were recorded. Propulsion at 1.6m/s generated significantly higher EMG intensities in biceps brachii, anterior deltoid, pectoralis major, and middle deltoid than at 1m/s and 1.3m/s. The combined wavelet and principal component analysis showed that the faster propulsion speed requires higher push muscle activity in the early push phase and in the phase transitions between alternating push and recovery. Training to strengthen the shoulder flexors to achieve smoother phase transitions could improve rehabilitation outcomes by increasing functional speed while lessening shoulder strain.
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Leving MT, Vegter RJK, de Vries WHK, de Groot S, van der Woude LHV. Changes in propulsion technique and shoulder complex loading following low-intensity wheelchair practice in novices. PLoS One 2018; 13:e0207291. [PMID: 30412627 PMCID: PMC6226177 DOI: 10.1371/journal.pone.0207291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/29/2018] [Indexed: 11/18/2022] Open
Abstract
Background Up to 80% of wheelchair users are affected by shoulder pain. The Clinical Practice Guidelines for preservation of upper limb function following spinal cord injury suggest that using a proper wheelchair propulsion technique could minimize the shoulder injury risk. Yet, the exact relationship between the wheelchair propulsion technique and shoulder load is not well understood. Objective This study aimed to examine the changes in shoulder loading accompanying the typical changes in propulsion technique following 80 min of low-intensity wheelchair practice distributed over 3 weeks. Methods Seven able-bodied participants performed the pre- and the post-test and 56 min of visual feedback-based low-intensity wheelchair propulsion practice. Kinematics and kinetics of propulsion technique were recorded during the pre- and the post-test. A musculoskeletal model was used to calculate muscle force and glenohumeral reaction force. Results Participants decreased push frequency (51→36 pushes/min, p = 0.04) and increased contact angle (68→94°, p = 0.02) between the pre- and the post-test. The excursion of the upper arm increased, approaching significance (297→342 mm, p = 0.06). Range of motion of the hand, trunk and shoulder remained unchanged. The mean glenohumeral reaction force per cycle decreased by 13%, approaching significance (268→232 N, p = 0.06). Conclusions Despite homogenous changes in propulsion technique, the kinematic solution to the task varied among the participants. Participants exhibited two glenohumeral reaction force distribution patterns: 1) Two individuals developed high force at the onset of the push, leading to increased peak and mean glenohumeral forces 2) Five individuals distributed the force more evenly over the cycle, lowering both peak and mean glenohumeral forces.
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Affiliation(s)
- Marika T. Leving
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| | - Riemer J. K. Vegter
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Sonja de Groot
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - Lucas H. V. van der Woude
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Maguire CC, Sieben JM, De Bie RA. Movement goals encoded within the cortex and muscle synergies to reduce redundancy pre and post-stroke. The relevance for gait rehabilitation and the prescription of walking-aids. A literature review and scholarly discussion. Physiother Theory Pract 2018; 35:1-14. [PMID: 29400592 DOI: 10.1080/09593985.2018.1434579] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Current knowledge of neural and neuromuscular processes controlling gait and movement as well as an understanding of how these mechanisms change following stroke is an important basis for the development of effective rehabilitation interventions. To support the translation of findings from basic research into useful treatments in clinical practice, up-to-date neuroscience should be presented in forms accessible to all members of the multidisciplinary team. In this review we discuss aspects of cortical control of gait and movement, muscle synergies as a way of translating cortical commands into specific muscle activity and as an efficient means of reducing neural and musculoskeletal redundancy. We discuss how these mechanisms change following stroke, potential consequences for gait rehabilitation, and the prescription and use of walking-aids as well as areas requiring further research.
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Affiliation(s)
- Clare C Maguire
- a Department of Physiotherapy, BZG Bildungszentrum Gesundheit Basel-Stadt , Munchenstein , Switzerland.,b Health Division , Bern University of Applied Science , Bern , Switzerland.,c Caphri Research School , Maastricht University , Maastricht , the Netherlands
| | - Judith M Sieben
- c Caphri Research School , Maastricht University , Maastricht , the Netherlands.,d Department of Anatomy and Embryology , Maastricht University , Maastricht , the Netherlands
| | - Robert A De Bie
- c Caphri Research School , Maastricht University , Maastricht , the Netherlands.,e Department of Epidemiology , Maastricht University , Maastricht , the Netherlands
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van Dijsseldonk RB, Rijken H, van Nes IJW, van de Meent H, Keijsers NLW. A Framework for Measuring the Progress in Exoskeleton Skills in People with Complete Spinal Cord Injury. Front Neurosci 2017; 11:699. [PMID: 29311780 PMCID: PMC5732998 DOI: 10.3389/fnins.2017.00699] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/28/2017] [Indexed: 12/19/2022] Open
Abstract
For safe application of exoskeletons in people with spinal cord injury at home or in the community, it is required to have completed an exoskeleton training in which users learn to perform basic and advanced skills. So far, a framework to test exoskeleton skills is lacking. The aim of this study was to develop and test the hierarchy and reliability of a framework for measuring the progress in the ability to perform basic and advanced skills. Twelve participants with paraplegia were given twenty-four training sessions in 8 weeks with the Rewalk-exoskeleton. During the 2nd, 4th, and 6th training week the Intermediate-skills-test was performed consisting of 27 skills, measured in an hierarchical order of difficulty, until two skills were not achieved. When participants could walk independently, the Final-skills-test, consisting of 20 skills, was performed in the last training session. Each skill was performed at least two times with a maximum of three attempts. As a reliability measure the consistency was used, which was the number of skills performed the same in the first two attempts relative to the total number. Ten participants completed the training program. Their number of achieved intermediate skills was significantly different between the measurements XF2(2) = 12.36, p = 0.001. Post-hoc analysis revealed a significant increase in the median achieved intermediate skills from 4 [1–7] at the first to 10.5 [5–26] at the third Intermediate-skills-test. The rate of participants who achieved the intermediate skills decreased and the coefficient of reproducibility was 0.98. Eight participants met the criteria to perform the Final-skills-test. Their median number of successfully performed final skills was 16.5 [13–20] and 17 [14–19] skills in the first and second time. The overall consistency of >70% was achieved in the Intermediate-skills-test (73%) and the Final-skills-test (81%). Eight out of twelve participants experienced skin damage during the training, in four participants this resulted in missed training sessions. The framework proposed in this study measured the progress in performing basic and advanced exoskeleton skills during a training program. The hierarchical ordered skills-test could discriminate across participants' skill-level and the overall consistency was considered acceptable.
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Affiliation(s)
| | - Hennie Rijken
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Ilse J W van Nes
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands
| | | | - Noel L W Keijsers
- Department of Research, Sint Maartenskliniek Research, Nijmegen, Netherlands.,Department of Rehabilitation, Radboudumc, Nijmegen, Netherlands
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