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Effect of backrest height on wheelchair propulsion biomechanics for level and uphill conditions

Yang, YS and Koontz, AM and Yeh, SJ and Chang, JJ (2012) Effect of backrest height on wheelchair propulsion biomechanics for level and uphill conditions. Archives of Physical Medicine and Rehabilitation, 93 (4). 654 - 659. ISSN 0003-9993

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Effect of backrest height on wheelchair propulsion biomechanics for level and uphill conditions. Objective: To evaluate the effect of backrest height on wheelchair propulsion kinematics and kinetics. Design: An intervention study with repeated measures. Setting: University laboratory. Participants: Convenience sample included manual wheelchair users (N=36; 26 men and 10 women) with spinal cord injuries ranging from T8 to L2. Intervention: Participants propelled on a motor-driven treadmill for 2 conditions (level and slope of 3°) at a constant speed of 0.9m/s while using in turn a sling backrest fixed at 40.6cm (16in) high (high backrest) and a lower height set at 50% trunk length (low backrest). Main Outcome Measures: Cadence, stroke angle, peak shoulder extension angle, shoulder flexion/extension range of motion, and mechanical effective force. Results: Pushing with the low backrest height enabled greater range of shoulder motion (P<.01), increased stroke angle (P<.01), push time (P<.01), and reduced cadence (P=.01) regardless of whether the treadmill was level or sloped. Conclusions: A lower cadence can be achieved when pushing with a lower backrest, which decreases the risk of developing upper-limb overuse related injuries. However, postural support, comfort, and other activities of daily living must also be considered when selecting a backrest height for active, long-term wheelchair users. The improvements found when using the low backrest were found regardless of slope type. Pushing uphill demanded significantly higher resultant and tangential force, torque, mechanical effective force, and cadence. © 2012 by the American Congress of Rehabilitation Medicine.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Yang, YS
Koontz, AMakoontz@pitt.eduAKOONTZ
Yeh, SJ
Chang, JJ
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 April 2012
Date Type: Publication
Journal or Publication Title: Archives of Physical Medicine and Rehabilitation
Volume: 93
Number: 4
Page Range: 654 - 659
DOI or Unique Handle: 10.1016/j.apmr.2011.10.023
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0003-9993
MeSH Headings: Acceleration; Adaptation, Physiological; Adult; Aged; Biomechanics; Equipment Design; Female; Humans; Male; Middle Aged; Psychomotor Performance; Range of Motion, Articular--physiology; Spinal Cord Injuries--physiopathology; Torque; Upper Extremity--physiology; Wheelchairs
PubMed ID: 22325682
Date Deposited: 15 Oct 2012 14:17
Last Modified: 02 Feb 2019 16:56


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