Comparing handrim biomechanics for treadmill and overground wheelchair propulsion

A M Kwarciak, J T Turner, L Guo, W M Richter, A M Kwarciak, J T Turner, L Guo, W M Richter

Abstract

Study design: Cross-sectional study.

Objectives: To compare handrim biomechanics recorded during overground propulsion with those recorded during propulsion on a motor-driven treadmill.

Setting: Biomechanics laboratory.

Methods: In all, 28 manual wheelchair users propelled their own wheelchairs, at a self-selected speed, on a low-pile carpet and on a wheelchair accessible treadmill. Handrim biomechanics were recorded with an OptiPush instrumented wheelchair wheel.

Results: Across the two conditions, all handrim biomechanics were found to be similar and highly correlated (r>0.85). Contact angle, peak force, average force and peak axle moment differed by 1.6% or less across the two conditions. Although not significant, power output and cadence tended to be slightly higher for the treadmill condition (3.5 and 3.6%, respectively), owing to limitations in adjusting the treadmill grade.

Conclusion: Based on the results of this study, a motor-driven treadmill can serve as a valid surrogate for overground studies of wheelchair propulsion.

Conflict of interest statement

Conflict of interest

We confirm that we have a financial interest in the subject matter and materials discussed in this manuscript. The authors are all employed by MAX Mobility, LLC, which currently offers a wheelchair-accessible treadmill. By demonstrating the similarity of treadmill propulsion to overground propulsion, we could gain from the potential increase in treadmill sales.

Figures

Figure 1
Figure 1
Photo of the treadmill test setup.
Figure 2
Figure 2
Plots of the variables (top row: cadence, contact angle, peak force; bottom row: average force, peak moment, and power output). Each plot includes a line of equality (y = x) to show the proximity of the points to being equal across the treadmill and overground conditions.
Figure 3
Figure 3
Bland-Altman plot of cadence. The solid line represents the mean difference in cadence between pushing on a treadmill and pushing overground; and the dashed lines define the 95% confidence interval.

References

    1. Boninger ML, Cooper RA, Baldwin MA, Shimada SD, Koontz AM. Wheelchair pushrim kinetics: body weight and median nerve function. Arch Phys Med Rehab. 1999;80:910–915.
    1. Mercer JL, Boninger M, Koontz A, Ren D, Dyson-Hudson T. Shoulder joint kinetics and pathology in manual wheelchair users. Clin Biomech (Bristol, Avon) 2006;21:781–789.
    1. Desroches G, Dumas R, Pradon D, Vaslin P, Lepoutre FX, Cheze L. Upper limb joint dynamics during manual wheelchair propulsion. Clin Biomech (Bristol, Avon) 2010;25:299–306.
    1. Koontz AM, Roche BM, Collinger JL, Cooper RA, Boninger ML. Manual wheelchair propulsion patterns on natural surfaces during start-up propulsion. Arch Phys Med Rehabil. 2009;90:1916–1923.
    1. Cowan RE, Nash MS, Collinger JL, Koontz AM, Boninger ML. Impact of surface type, wheelchair weight, and axle position on wheelchair propulsion by novice older adults. Arch Phys Med Rehabil. 2009;90:1076–1083.
    1. Rice I, Gagnon D, Gallagher J, Boninger M. Hand rim wheelchair propulsion training using biomechanical real-time visual feedback based on motor learning theory principles. J Spinal Cord Med. 2010;33:33–42.
    1. DeGroot KK, Hollingsworth HH, Morgan KA, Morris CL, Gray DB. The influence of verbal training and visual feedback on manual wheelchair. Disabil Rehabil Assist Technol. 2009;4:86–94.
    1. Lighthall-Haubert L, Requejo PS, Mulroy SJ, Newsam CJ, Bontrager E, Gronley JK, Perry J. Comparison of shoulder muscle electromyographic activity during standard manual wheelchair and push-rim activated power assisted wheelchair propulsion in persons with complete tetraplegia. Arch Phys Med Rehabil. 2009;90:1904–1915.
    1. Gil-Agudo A, Ama-Espinosa A, Perez-Rizo E, Perez-Nombela S, Crespo-Ruiz B. Shoulder joint kinetics during wheelchair propulsion on a treadmill at two different speeds in spinal cord injury patients. Spinal Cord. 2010;48:290–296.
    1. Bregman DJ, Drongelen SV, Veeger HE. Is effective force application in handrim wheelchair propulsion also efficient? Clin Biomech (Bristol., Avon.) 2009;24:13–19.
    1. Richter WM, Rodriguez R, Woods KR, Axelson PW. Stroke pattern and handrim biomechanics for level and uphill wheelchair propulsion at self-selected speeds. Arch Phys Med Rehab. 2007;88:81–87.
    1. Van der Woude LH, Veeger HE, Dallmeijer AJ, Janssen TWJ, Rozendaal LA. Biomechanics and physiology in active manual wheelchair propulsion. Med Engr Phys. 2001;23:713–733.
    1. Haisma JA, Van der Woude LH, Stam HJ, Bergen MP, Sluis TA, Bussmann JB. Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature. Spinal Cord. 2006;44:642–652.
    1. Stephens CL, Engsberg JR. Comparison of overground and treadmill propulsion patterns of manual wheelchair users with tetraplegia. Disabil Rehabil Assist Technol. 2010 (Epub ahead of print)
    1. Cooper RA, DiGiovine CP, Boninger ML, Shimada SD, Robertson RN. Frequency Analysis of 3-Dimensional Pushrim Forces and Moments for Manual Wheelchair Propulsion. Automedica. 1998;16:355–365.
    1. De Groot S, Veeger HE, Hollander AP, Van der Woude LH. Effect of wheelchair stroke pattern on mechanical efficiency. Am J Phys Med Rehabil. 2004;83:640–649.
    1. Koontz AM, Cooper RA, Boninger ML, Yang Y, Impink BG, Van der Woude LH. A kinetic analysis of manual wheelchair propulsion during start-up on select indoor and outdoor surfaces. J Rehabil Res Dev. 2005;42:447–458.
    1. Preservation of upper limb function following spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med. 2005;28:434–470.
    1. van Ingen Schenau GJ. Some fundamental aspects of the biomechanics of overground versus treadmill locomotion. Med Sci Sports Exer. 1980;12:257–261.
    1. Cooper RA. A systems approach to the modeling of racing wheelchair propulsion. J Rehab Res Dev. 1990;27:151–162.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться