Pushrim biomechanics and injury prevention in spinal cord injury: Recommendations based on CULP-SCI investigations
Pushrim biomechanics and injury prevention in spinal cord injury: Recommendations based on CULP-SCI investigations
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DOI：
10.1682/jrrd.2004.08.0103
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发表时间：
2005-05-01
影响因子：
--
通讯作者：
Cooper, RA
中科院分区：
文献类型：
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作者：
Boninger, ML;Koontz, AM;Cooper, RA
超过50%患有脊髓损伤（SCI）的手动轮椅使用者可能会出现上肢疼痛和损伤。大多数与疼痛相关的研究都将轮椅推进力作为一个原因。本文从一个大型多地点试验和一个长期的研究项目中得出了与轮椅推进相关的具体建议，这些建议可能会降低上肢损伤的风险。这些研究包括超过60名受试者超过1年后，创伤性脊髓损伤低于第二胸椎水平。可能与损伤有关的推进性划水的具体方面包括节奏、力量大小和划水非推进部分的手的模式。较低的峰值力量，较慢的节奏，以及在恢复过程中手福尔斯落在推缘下方的圆形推进划水可能有助于防止受伤。此外，轮椅使用者应尽可能使用重量最轻的可调节轮椅。未来的工作应该包括干预性试验和更大规模的研究，这些研究允许更复杂的统计模型，可以进一步详细说明轮椅推进力，用户特征和上肢损伤之间的关系。
Over 50 percent of manual wheelchair users with spinal cord injury (SCI) are likely to develop upper-limb pain and injury. The majority of studies related to pain have implicated wheelchair propulsion as a cause. This paper draws from a large multisite trial and a long-standing research program to make specific recommendations related to wheelchair propulsion that may decrease the risk of upper-limb injury. The studies include over 60 subjects over 1 yr after a traumatic SCI below the second thoracic level. Specific aspects of the propulsive stroke that may relate to injury include cadence, magnitude of force, and the pattern of the hand during the nonpropulsive part of the stroke. Lower peak forces, slower cadence, and a circular propulsive stroke in which the hand falls below the pushrim during recovery may help prevent injury. In addition, wheelchair users should use the lightest weight adjustable wheelchair possible. Future work should include interventional trials and larger studies that allow for more complex statistical models that can further detail the relationship between wheelchair propulsion, user characteristics, and upper-limb injuries.