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Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion

Boninger, ML and Souza, AL and Cooper, RA and Fitzgerald, SG and Koontz, AM and Fay, BT (2002) Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion. Archives of Physical Medicine and Rehabilitation, 83 (5). 718 - 723. ISSN 0003-9993

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Objectives: To classify stroke patterns of manual wheelchair users and to determine if different patterns of propulsion lead to different biomechanics. Design: Case series. Setting: Biomechanics laboratory. Participants: Thirty-eight individuals with paraplegia who use manual wheelchairs for mobility. Intervention: Subjects propelled their own wheelchair on a dynamometer at 2 different steady state speeds. Bilateral biomechanical data were obtained by using a force and moment sensing pushrim and a motion analysis system. Main Outcome Measures: The propulsive stroke of each participant for each speed and side was classified as following 1 of 4 patterns. These 4 patterns were then compared by using a mixed-model analysis of variance. The biomechanical variables that were compared were cadence, peak and rate of rise of the resultant force, mechanical effective force, push angle, and ratio of time spent pushing to time in recovery. Results: The most common propulsive stroke involved the user lifting the hand over the pushrim during the recovery phase. The stroke pattern was independent of axle position and varied from side to side and between speeds. After controlling for subject characteristics, significant differences were observed between stroke patterns in cadence and ratio of time spent pushing to time in recovery. A stroke pattern that involves using a semicircular motion with the hand below the pushrim during the recovery phase of the propulsion stroke was associated with a lower cadence and more time spent in the push phase relative to the recovery phase. Conclusion: The semicircular motion of propulsion displayed characteristics consistent with reduced repetition and more efficient propulsion. Use of this propulsion style may reduce trauma to the upper extremities. Clinicians should consider training individuals in this propulsion style. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Boninger, MLboninger@pitt.eduBONINGER
Souza, AL
Fitzgerald, SG
Koontz, AMakoontz@pitt.eduAKOONTZ
Fay, BT
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 January 2002
Date Type: Publication
Journal or Publication Title: Archives of Physical Medicine and Rehabilitation
Volume: 83
Number: 5
Page Range: 718 - 723
DOI or Unique Handle: 10.1053/apmr.2002.32455
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0003-9993
MeSH Headings: Adult; Aged; Arm--physiopathology; Biomechanics; Female; Humans; Locomotion--physiology; Male; Middle Aged; Paraplegia--physiopathology; Pattern Recognition, Visual--classification; Pattern Recognition, Visual--physiology; Range of Motion, Articular--physiology; Wheelchairs
PubMed ID: 11994814
Date Deposited: 25 Sep 2012 14:23
Last Modified: 05 Feb 2019 03:55


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