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Manual Wheelchair Propulsion in Older Adults

Cowan, Rachel E (2007) Manual Wheelchair Propulsion in Older Adults. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Compared to individuals with spinal cord injury (SCI), propulsion by older adults is poorly defined. The goal of this project is to examine the impact of wheelchair, surface, and user characteristics on propulsion mechanics in older adults and individuals with SCI. All participants self-propelled over a series of surfaces at a self-selected velocity and kinetic data collection were provided by the SmartWheel. We described a standard clinical protocol (SCP) for objective assessment of manual wheelchair propulsion and defined reference values for individuals with SCI based this protocol (N=128). The SCP requires self-propulsion over tile, low pile carpet, and up an ADA ramp. In addition we provided a decision framework based on graphical reference data; guiding clinicians through an objective assessment of propulsion, identifying opportunities for intervention and follow-up. We then compared propulsion of individuals with paraplegia (IP, N=54) and older adults (OA, N=53). OA propelled slower than IP; used a greater push frequency and minimum Mz, shorter stroke length, and similar resultant force. When surface difficulty increased, the IP group responded with increased work. This may indicate a lack of capacity in OA to respond to increased resistance. For our cohort of older adults we defined the impact of surface type, wheelchair weight, and rear axle position (N=53). As surface difficulty or chair weight increased, velocity decreased. Controlling for velocity, push frequency, resultant and tangential force increased as surface difficulty increased; heavier chairs had decreased stroke length and increased resultant and tangential force; and posterior axle positions had increased velocity. Controlling for velocity, posterior axle positions had increased forces. Finally, we examined the impact of strength and gender. Body-weight normalized grip strength was collected. Stronger individuals propel faster than weaker individuals. On low pile carpet, both genders decreased velocity versus tile, but women decreased push frequency while men increased. Surface type has a substantial impact on propulsion velocity and force; magnifying any differences between users and wheelchair configurations. Wheelchair weight and axle position independently affect propulsion mechanics. Gender and strength appear to influence propulsion. Older adults are marginal self-propellers at best; powered mobility may be a more appropriate mobility solution.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Cowan, Rachel
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBoninger, Michaelboninger@pitt.eduBONINGER
Committee MemberKoontz,
Committee MemberFitzgerald,
Committee MemberStudenski, Stephaniestudenskis@dom.pitt.eduSAS33
Date: 19 December 2007
Date Type: Completion
Defense Date: 19 November 2007
Approval Date: 19 December 2007
Submission Date: 6 December 2007
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: older adults; propulsion; rehabilitation; spinal cord injury; wheelchair
Other ID:, etd-12062007-081607
Date Deposited: 10 Nov 2011 20:08
Last Modified: 15 Nov 2016 13:53


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