Biomechanics of Wheelchair Propulsion

描述（由申请人提供）：超过150万美国人依靠手动轮椅行动，超过一半的人报告他们的肩膀和/或其他上肢（UE）关节疼痛。虽然已经投入了大量的研究来理解轮椅推进的生物力学，但没有明确的答案来确定这种疼痛的病因。这可能是由于实验室收集的轮椅推进力可能不能完全代表现实生活条件。到目前为止，还没有数据可以比较实验室和现场轮椅推进生物力学的测量结果。此外，目前可用的描述关节节段间负荷的运动学和动力学数据可能不足以解释特定肌肉和软组织的负荷。我们建议通过与计算机建模相结合，开始获得基于现场的数据，以获得对轮椅推进的更深入的理解。该项目的第一个目的是对比室外轮椅推进过程中施加的力和力矩，使用一对无线仪器车轮和轮椅测力仪在推进过程中收集的数据，在室外试验中记录的速度和功率。这项研究的第二个目标将涉及开发肌肉骨骼模型，以确定受试者在平地上、斜坡上和沿着斜坡推进时的激活模式。优化技术将用于确定肌肉力量分布，模型结果将通过与肌电图数据的相关性进行验证。这样一个经过验证的模型将有助于了解用户在不同地形上推进时UE肌肉反应的变化。我们的目的是在用户的自然环境中提供一个更真实的UE节间关节负荷和肌肉力的图像。随后，这将有助于发展治疗手段，以保护肩膀免受伤害。

DESCRIPTION (provided by applicant): Over 1.5 million Americans rely on manual wheelchairs for mobility, and over half report experiencing pain in their shoulders and/or other upper extremity (UE) joints. While there has been a great amount of research invested towards understanding the biomechanics of wheelchair propulsion, no definitive answers have been produced to determine the etiology of this pain. This may be due to the fact that laboratory collection of wheelchair propulsion may not fully represent real life conditions. To date, no data exists that compares laboratory versus field based measurements of wheelchair propulsion biomechanics. Additionally, currently available kinematic and kinetic data describing joint intersegmenal loads may not be adequate for explaining the loading on specific muscles and soft tissues. We propose to gain a deeper understanding of wheelchair propulsion by starting to obtain field-based data in combination with computer modeling. The first aim of this project is to contrast the forces and moments exerted during outdoor wheelchair propulsion using a pair of wireless instrumented wheels with data collected on a wheelchair ergometer during propulsion at the speed and power recorded during the outdoor trial. The second aim of the-study will involve the development of a musculoskeletal model to determine the activation patterns of the subjects as they propel on level ground, up a ramp, and along a sideslope. Optimization techniques will be used to determine muscle force distribution and model results will be validated through correlation with EMG data. Such a validated model will lend insight as to the changes in UE muscle response as users propel over varied terrains. It is our intent to provide a more realistic picture of UE intersegmental joint loads and muscle forces in the natural environment of the user. Subsequently this will aid in the development of therapeutic means to protect the shoulder from injury.