https://www.archives-pmr.org/article/S0003-9993(02)58195-8/pdf

Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion

Wheelchair pushrim kinetics: body weight and median nerve function.

This guideline has been prepared based on the scientific and professional information available in 2004. Users of this guideline should periodically review this material to ensure that the advice herein is consistent with current reasonable clinical practice.

Preservation of upper limb function following spinal cord injury: a clinical practice guideline for health-care professionals.

Shoulder joint kinetics and pathology in manual wheelchair users.

Biomechanics and physiology in active manual wheelchair propulsion

https://www.archives-pmr.org/article/S0003-9993(96)90270-1/pdf

Pushrim forces and joint kinetics during wheelchair propulsion

This technical note illustrates that some of the differences that have been reported regarding wheelchair propulsion may be due to the methods used to calculate key variables. Wheelchair ambulation is a very important form of locomotion that lacks a standard pushrim force and moment analysis system. We have developed tools for analyzing upper limb biomechanics during manual wheelchair propulsion. Among the tools is a system that allows the direct measurement of global coordinate forces F(x), F(y), F(z) and corresponding moments. The analytical techniques presented here allow calculation of radial (F(r)) and tangential (F(t)) forces, the determination of point of force application (PFA), and the moment applied by the hand (M(hz)). Our results show that the PFA can be calculated from kinetic data. Comparison of the PFA to the second metacarpophalangeal (MP) joint, calculated from kinematic data and used in previous studies, resulted in a 0.2 radian difference on average, with the PFA showing greater variation near the beginning and ending of the propulsion phase. Analysis of methods for calculating the applied tangential force showed that using the PFA provides a more accurate measurement of this force than the previous method of assuming negligible hand-moment contribution. The hand moment was compared using the calculated PFA and assuming the PFA was coincident with the second MP joint. Both methods provided similar results with a mean difference of 0.6 N x m. The methods presented in this paper provide a framework for analyzing wheelchair propulsion forces and moments.

/pdf/methods-for-determining-three-dimensional-wheelchair-pushrim-5d0af9lyz0.pdf

Methods for determining three-dimensional wheelchair pushrim forces and moments: a technical note.

Upper limb pain frequently occurs in manual wheelchair users. Analyzing the pushrim forces and hub moments occurring during wheelchair propulsion is a first step in gaining insight into the cause of this pain. The objectives of this study were as follows: to describe the forces and moments occurring during wheelchair propulsion; to obtain variables that characterize pushrim forces and are statistically stable; and to determine how these variables change with speed. Convenience samples (n = 6) of paralympic athletes who use manual wheelchairs for mobility and have unimpaired arm function were tested. Each subject propelled a standard wheelchair on a dynamometer at 1.3 and 2.2 m/s. Biomechanical data were obtained using a force- and moment-sensing pushrim and a motion analysis system. A number of variables that describe the force and moment curves were evaluated for stability using Cronbach's alpha. Those measures found to be stable (alpha > 0.8) at each speed were then examined for differences associated with speed. The tangential, radial, and medial-lateral forces were found to comprise approximately 55, 35, and 10% of the resultant force, respectively. In addition to duration of stroke and propulsion, the following variables were found to be stable and to differ with speed (1.3 m/s +/- SD; 2.2 m/s +/- SD): peak force tangential to the pushrim (45.9 +/- 17.9 N; 62.1 +/- 30 N), peak moment radial to the hub (9.8 +/- 4.5 N x m 13.3 +/- 6 N x m), maximum rate of rise of the tangential force (911.7 +/- 631.7 N/sec; 1262.3 +/- 570.7 N/sec), and maximum rate of rise of the moment about the hub (161.9 +/- 78.3 N x m/s; 255.2 +/- 115.4 N x m/s). This study found stable parameters that characterize pushrim forces during wheelchair propulsion and varied with speed. Almost 50% of the forces exerted at the pushrim are not directed toward forward motion and, therefore, either apply friction to the pushrim or are wasted. Ultimately, this type of investigation may provide insight into the cause and prevention of upper limb injuries in manual wheelchair users.

Three-dimensional pushrim forces during two speeds of wheelchair propulsion

Rehabilitation scientists and biomedical engineers have been investigating wheelchair propulsion biomechanics in order to prevent musculoskeletal injuries. Several studies have investigated wheelchair propulsion biomechanics; however, few have examined wheelchair propulsion stroke patterns. The purpose of this study was to characterize wheelchair propulsion stroke patterns by investigating joint accelerations, joint range of motions, wheelchair propulsion phases, and stroke efficiency. Seven experienced wheelchair users (5 males, 2 females) were filmed using a three-camera motion analysis system. Each subject pushed a standard wheelchair fitted with a force-sensing pushrim (SMARTWheel) at two speeds (1.3 and 2.2 m/s). The elbow angle was analyzed in the sagittal plane, while the shoulder joint was analyzed in the sagittal and frontal planes. Three distinctly different stroke patterns: semi-circular (SC), single looping-over-propulsion (SLOP), and double looping-over-propulsion (DLOP), were identified from the kinematic analysis. Through our analysis of these patterns, we hypothesized that SC was more biomechanically efficient than the other stroke patterns. Future studies using a larger number of subjects and strokes may reveal more significant distinctions in efficiency measures between stroke patterns.

/pdf/kinematic-characterization-of-wheelchair-propulsion-52yf35y51u.pdf

S.D. Shimada

Papers

Wheelchair pushrim kinetics: body weight and median nerve function.

Pushrim forces and joint kinetics during wheelchair propulsion

Methods for determining three-dimensional wheelchair pushrim forces and moments: a technical note.

Three-dimensional pushrim forces during two speeds of wheelchair propulsion

Kinematic characterization of wheelchair propulsion