Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion
Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion
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DOI：
10.1053/apmr.2002.32455
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发表时间：
2002-05-01
影响因子：
4.3
通讯作者：
Fay, BT
中科院分区：
文献类型：
--
作者：
Boninger, ML;Souza, AL;Fay, BT
目的：分类中风模式的手动轮椅使用者，并确定是否不同的模式的推进导致不同的biomechanics.Design：病例系列。设置：Biomechanics laboratory。参与者：38个人截瘫谁使用手动轮椅mobility.Intervention：主题推动自己的轮椅上测力计在2个不同的稳态速度。双侧生物力学数据通过使用力和力矩传感pushrim和运动分析system.Main结果measurements：推进中风的每个参与者的每个速度和侧被归类为以下4种模式之一。然后通过使用混合模型方差分析来比较这4种模式。比较的生物力学变量有节奏，合力的峰值和上升率，机械有效力，推角。结果：最常见的推进行程包括使用者在恢复阶段举起，手放在推缘上。行程模式是独立的轴的位置和变化，从一侧到另一侧和速度之间。在控制了受试者的特征后，观察到中风模式在节奏和推动时间与恢复时间的比值方面存在显着差异。一个中风模式，涉及使用一个半圆形的运动与下面的pushrim的手在恢复阶段的推进中风与较低的节奏和更多的时间花在推动阶段相对于recovery phases.Conclusion：推进的半圆形运动显示的特点与减少重复和更有效的推进一致。使用这种推进方式可以减少对上肢的创伤。临床医生应考虑对个人进行这种推进方式的培训。(C)2002年由美国康复医学大会和美国物理医学和康复学会。
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. (C) 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.