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Manual Wheelchair Propulsion Patterns on Natural Surfaces During Start-Up Propulsion

Koontz, AM and Roche, BM and Collinger, JL and Cooper, RA and Boninger, ML (2009) Manual Wheelchair Propulsion Patterns on Natural Surfaces During Start-Up Propulsion. Archives of Physical Medicine and Rehabilitation, 90 (11). 1916 - 1923. ISSN 0003-9993

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Abstract

Koontz AM, Roche BM, Collinger JL, Cooper RA, Boninger ML. Manual wheelchair propulsion patterns on natural surfaces during start-up propulsion. Objectives: To classify propulsion patterns over surfaces encountered in the natural environment during start-up and compare selected biomechanical variables between pattern types. Design: Case series. Setting: National Veterans Wheelchair Games, Minneapolis, MN, 2005. Participants: Manual wheelchair users (N=29). Intervention: Subjects pushed their wheelchairs from a resting position over high-pile carpet, over linoleum, and up a ramp with a 5° incline while propulsion kinematics and kinetics were recorded with a motion capture system and an instrumented wheel. Main Outcome Measures: Three raters classified the first 3 strokes as 1 of 4 types on each surface: arc, semicircular (SC), single looping over propulsion (SL), and double looping over propulsion (DL). The Fisher exact test was used to assess pattern changes between strokes and surface type. A multiple analysis of variance test was used to compare peak and average resultant force and moment about the hub, average wheel velocity, stroke frequency, contact angle, and distance traveled between stroke patterns. Results: SL was the most common pattern used during start-up propulsion (44.9%), followed by arc (35.9%), DL (14.1%), and SC (5.1%). Subjects who dropped their hands below the rim during recovery achieved faster velocities and covered greater distances (.016≤P≤.075) during start-up on linoleum and carpet and applied more force during start-up on the ramp compared with those who used an arc pattern (P=.066). Conclusions: Classifying propulsion patterns is a difficult task that should use multiple raters. In addition, propulsion patterns change during start-up, with an arc pattern most prevalent initially. The biomechanical findings in this study agree with current clinical guidelines that recommend training users to drop the hand below the pushrim during recovery. © 2009 American Congress of Rehabilitation Medicine.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Koontz, AMakoontz@pitt.eduAKOONTZ
Roche, BM
Collinger, JLcollinger@pitt.eduCOLLINGR
Cooper, RARCOOPER@pitt.eduRCOOPER
Boninger, MLboninger@pitt.eduBONINGER
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 November 2009
Date Type: Publication
Journal or Publication Title: Archives of Physical Medicine and Rehabilitation
Volume: 90
Number: 11
Page Range: 1916 - 1923
DOI or Unique Handle: 10.1016/j.apmr.2009.05.022
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0003-9993
MeSH Headings: Adult; Analysis of Variance; Arm--physiopathology; Biomechanics; Equipment Design; Female; Floors and Floorcoverings; Humans; Kinetics; Locomotion--physiology; Male; Spinal Cord Injuries--physiopathology; Surface Properties; Task Performance and Analysis; Veterans; Wheelchairs
PubMed ID: 19887217
Date Deposited: 15 Oct 2012 14:13
Last Modified: 09 Nov 2019 15:55
URI: http://d-scholarship.pitt.edu/id/eprint/15770

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