Pushrim forces and joint kinetics during wheelchair propulsion. 1996

R N Robertson, and M L Boninger, and R A Cooper, and S D Shimada
Department of Orthopaedic Surgery, School of Health and Rehabilitation Sciences, University of Pittsburgh, USA.

OBJECTIVE To investigate pushrim forces and joint kinetics during wheelchair propulsion and to discuss the differences between inexperienced and experienced wheelchair users. METHODS Cohort study. METHODS Human engineering laboratory at a state university. METHODS Four men who use manual wheelchairs for mobility and four nondisabled men who did not have extensive experience pushing a wheelchair; all subjects were asymptomatic for upper extremity pain or injury. METHODS Subjects pushed a commonly used wheelchair fitted with a force-sensing pushrim on a stationary wheelchair dynamometer. Video and force data were collected for 5 strokes at one speed of propulsion. Pushrim forces and net joint forces and moments were analyzed. METHODS Pushrim forces, radial (Fr) and tangential (Ft), were analyzed and compared for both groups in relation to peak values and time to peak values and as ratios of overall forces generated. Net joint forces and moments were analyzed in a similar fashion. RESULTS Pushrim forces and joint moments were similar to those previously reported, with radial forces averaging between 34 and 39N and tangential forces ranging on average between 66 and 95N. Tangential forces were higher than radial forces, and mean ratios of tangential forces to the resultant force were approximately 75%, whereas mean radial force ratios were approximately 22%. All subjects showed higher joint moments at the shoulder than at the elbow or wrist. A large component of vertical reaction force was seen at the shoulder. Significant differences (p < .05) were found between groups for peak tangential force and time to peak tangential and peak vertical forces, with wheelchair users having lower values and longer times to reach the peak values. CONCLUSIONS Discrete variables from the force-time curves can be used to distinguish between wheelchair users and nonusers. The experienced users tended to push longer, used forces with lower peaks, and took longer time to reach peak values. This propulsive pattern may have been developed to reduce the chance of injury by minimizing the forces at the joints, as a means of maximizing efficiency or as a combination of these factors. More work investigating 3-dimensional forces and the influence of seating position and various conditions of propulsion such as speed changes, ramps, and directional changes on injury mechanisms needs to be completed.

UI MeSH Term Description Entries
D007596 Joints Also known as articulations, these are points of connection between the ends of certain separate bones, or where the borders of other bones are juxtaposed. Joint
D007700 Kinetics The rate dynamics in chemical or physical systems.
D008297 Male Males
D009068 Movement The act, process, or result of passing from one place or position to another. It differs from LOCOMOTION in that locomotion is restricted to the passing of the whole body from one place to another, while movement encompasses both locomotion but also a change of the position of the whole body or any of its parts. Movement may be used with reference to humans, vertebrate and invertebrate animals, and microorganisms. Differentiate also from MOTOR ACTIVITY, movement associated with behavior. Movements
D012090 Cumulative Trauma Disorders Harmful and painful condition caused by overuse or overexertion of some part of the musculoskeletal system, often resulting from work-related physical activities. It is characterized by inflammation, pain, or dysfunction of the involved joints, bones, ligaments, and nerves. Overuse Syndrome,Repetition Strain Injury,Trauma Disorders, Cumulative,Injury, Repetition Strain,Overuse Injury,Repetitive Motion Disorders,Repetitive Strain Injury,Repetitive Stress Injury,Strain Injury, Repetition,Cumulative Trauma Disorder,Injury, Overuse,Injury, Repetitive Strain,Injury, Repetitive Stress,Motion Disorder, Repetitive,Overuse Injuries,Overuse Syndromes,Repetition Strain Injuries,Repetitive Motion Disorder,Repetitive Strain Injuries,Repetitive Stress Injuries,Strain Injury, Repetitive,Stress Injury, Repetitive,Trauma Disorder, Cumulative
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000886 Anthropometry The technique that deals with the measurement of the size, weight, and proportions of the human or other primate body.
D014910 Wheelchairs Chairs or seating mounted on wheels and designed to be controlled or propelled by the occupant. Medicare Part B (Medical Insurance) covers power-operated vehicles (scooters), walkers, and wheelchairs as durable medical equipment. Wheel Chairs,Chair, Wheel,Chairs, Wheel,Wheel Chair,Wheelchair
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence

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