An Investigation of Bilateral Symmetry During Manual Wheelchair Propulsion.
An Investigation of Bilateral Symmetry During Manual Wheelchair Propulsion.
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DOI：
10.3389/fbioe.2015.00086
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发表时间：
2015
影响因子：
5.7
通讯作者：
Neptune RR
中科院分区：
文献类型：
--
作者：
Soltau SL;Slowik JS;Requejo PS;Mulroy SJ;Neptune RR
为了简化数据收集、处理和分析，手动轮椅推进的研究通常假设两侧对称。然而，这种假设的有效性尚不清楚。大多数关于轮椅推进对称性的研究受限于相对较小的样本量和对单一推进条件的关注（例如，在自选速度下的水平推进）。本研究的目的是在不同的推进条件下，评估大量受试者在手动轮椅推进过程中的双侧对称性。本研究收集并处理了80名截瘫患者在固定式测力仪上推动轮椅时的三维运动学和handrim动力学以及时空变量。在三种不同的条件下：以自己选择的速度水平推进（自由），以自己最舒适的速度水平推进（快速），以及在自己选择的速度水平上以8%的速度推进（等级）。所有的运动学变量都有显著的侧面差异，主要是在分级条件下。推角是唯一具有显著左右差异的时空变量，且仅在分级条件下。没有动力学变量有显著的左右差异。运动差异的大小很低，只有一个差异超过5°。由于差异如此之小，在没有明显上肢疼痛或损伤的受试者中，在手动轮椅推进过程中，双侧对称假设似乎是合理的。然而，在继发性损伤和上肢疼痛以及不同病因的神经损伤患者中，可能存在较大的不对称。
Studies of manual wheelchair propulsion often assume bilateral symmetry to simplify data collection, processing, and analysis. However, the validity of this assumption is unclear. Most investigations of wheelchair propulsion symmetry have been limited by a relatively small sample size and a focus on a single propulsion condition (e.g., level propulsion at self-selected speed). The purpose of this study was to evaluate bilateral symmetry during manual wheelchair propulsion in a large group of subjects across different propulsion conditions. Three-dimensional kinematics and handrim kinetics along with spatiotemporal variables were collected and processed from 80 subjects with paraplegia while propelling their wheelchairs on a stationary ergometer during three different conditions: level propulsion at their self-selected speed (free), level propulsion at their fastest comfortable speed (fast), and propulsion on an 8% grade at their level, self-selected speed (graded). All kinematic variables had significant side-to-side differences, primarily in the graded condition. Push angle was the only spatiotemporal variable with a significant side-to-side difference, and only during the graded condition. No kinetic variables had significant side-to-side differences. The magnitudes of the kinematic differences were low, with only one difference exceeding 5°. With differences of such small magnitude, the bilateral symmetry assumption appears to be reasonable during manual wheelchair propulsion in subjects without significant upper-extremity pain or impairment. However, larger asymmetries may exist in individuals with secondary injuries and pain in their upper extremity and different etiologies of their neurological impairment.
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影响因子：
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作者：
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DOI：
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