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移动，超过一半的人报告说他们的肩膀和/或其他上肢关节疼痛。虽然已经投入了大量的研究来了解轮椅推进的生物力学，但还没有明确的答案来确定这种疼痛的原因。这可能是因为实验室收集的轮椅推进可能不能完全代表真实的生活条件。到目前为止，还没有数据比较基于实验室和现场的轮椅推进生物力学测量结果。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上的负荷。我们建议通过结合计算机建模开始获取基于现场的数据来获得对轮椅推进的更深入的理解。该项目的第一个目标是将使用一对无线仪表盘在室外轮椅推进过程中施加的力和力矩与轮椅测功器在室外试验中记录的速度和功率下的推进过程中收集的数据进行对比。这项研究的第二个目标将包括开发一个肌肉骨骼模型，以确定受试者在平地、坡道和斜坡上推进时的激活模式。优化技术将被用来确定肌肉力量分布，模型结果将通过与肌电数据的关联来验证。这种经过验证的模型将为用户在不同的地形上推进时UE肌肉反应的变化提供洞察力。我们的目的是提供一幅更真实的UE节间关节负荷和使用者自然环境中的肌肉力量的图片。随后，这将有助于开发保护肩部免受伤害的治疗手段。

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.