Comparative ergonomic assessment of manual wheelchairs by paraplegic users.

PURPOSE: The aim of the present study was to describe and test the reliability of a comprehensive product-centered approach to assessing functional performance and wheelchair user perceptions on device ergonomics and satisfaction of performance. A pilot study was implemented using this approach to evaluate differences among four manual wheelchairs. METHOD: Six wheelchair users with complete spinal cord injury (SCI) at the thoracic level and with no previous upper limbs impairment were recruited for this study. After finishing circuit tasks, subjects were asked to complete a questionnaire about ergonomic wheelchair characteristics (manoeuvrability, stability, comfort and ease of propulsion) and satisfaction about task performance. On the other hand, objective data were recorded during user performance as the time required to complete each test, kinetic wheelchair propulsion data obtained with two SMARTWheels® and physiological parameters (heart rate and physiological index). RESULTS: Kuschall Champion® and Otto Bock Voyage® wheelchairs were ranked best for most ergonomic aspects specially in manoeuvrability (p < 0.05). Less time was required to execute most of the circuit tasks in both wheelchair models (p < 0.05). CONCLUSIONS: This approach proposed highlight the importance of looking both kinds of information, user perception and user functional performance when evaluating a wheelchair or comparing across devices.

Physical activity and transcutaneous oxygen pressure in men with spinal cord injury.

This pilot study proposed a method for assessing the status of vascular flow measured by transcutaneous oxygen pressure (TcPO2) in the area of the ischium in people with spinal cord injury (SCI). In a sample of 38 men (two groups: 12 physically active and 26 sedentary) with thoracic SCI, the distribution of the physiological response of the tissues under load during sitting was assessed through analysis of ischium TcPO2 values obtained by an oximeter. TcPO2 baseline, recovery time of TcPO2 after sitting (Trec), the percentage of TcPO2 (%TcPO2) of maximum pressure TcPO2, and mechanic maximal pressure (Pmax) were evaluated. Trec in the physically active group was significantly lower (p < 0.05) than in the sedentary group. Likewise, significant differences in %TcPO2 between groups (p < 0.05) were also found. We concluded that the physiological response of the tissues under an individual with SCI's own weight resulting from prolonged sitting is better in those who are physically active.

[Application of virtual reality in the motor aspects of neurorehabilitation]. / Aplicación de la realidad virtual en los aspectos motores de la neurorrehabilitación.

INTRODUCTION: Virtual reality allows the user to interact with elements within a simulated scene. In recent times we have been witness to the introduction of virtual reality-based devices as one of the most significant novelties in neurorehabilitation. AIM: To review the clinical applications of the developments based on virtual reality for the neurorehabilitation treatment of the motor aspects of the most frequent disabling processes with a neurological origin. DEVELOPMENT: A review was carried out of the Medline, Physiotherapy Evidence Database, Ovid and Cochrane Library databases up until April 2009. This was completed with a web search using Google. No clinical trial conducted on its effectiveness has been found to date. The information that was collected is based on the description of the various prototypes produced by the different groups involved in their development. In most cases they are clinical trials conducted with a small number of patients, which have focused more on testing the validity of the device and checking whether it works correctly than on attempting to prove its clinical effectiveness. Although most of the clinical applications refer to patients with stroke, there were also several applications for patients with spinal cord injuries, multiple sclerosis, Parkinson's disease or balance disorders. CONCLUSIONS: Virtual reality is a novel tool with a promising future in neurorehabilitation. Further studies are needed to demonstrate its clinical effectiveness as compared to the traditional techniques.