Effect of handrim velocity on mechanical efficiency in wheelchair propulsion.

To study the effect of tangential speed of the handrims independent of external power output on gross mechanical efficiency (ME), nine able-bodied subjects performed wheelchair exercise tests on a stationary ergometer. The ergometer allowed for measurement of torque and three-dimensional forces on the rims and tangential velocity of the rear wheels. The experiment comprised two series of submaximal tests against constant external power outputs (0.25 and 0.50 W.kg-1) and four wheelchair speeds (0.83, 1.11, 1.39, and 1.67 m.s-1), which simulated a wheelchair speed of 1.67 m.s-1 and mechanical advantages of 0.43-0.87. ME stayed below 10.5% and changed inversely with speed of movement of the handrims. Peak torques on the right handrim stayed even with speed, leading to a significant increase in peak power output. Energy losses owing to braking torques at the beginning and end of the push phase increased with handrim speed but hardly exceeded 5 W. The effective force component applied to the handrims was below 71% of the magnitude of the total force vector and dropped up to 13% with increasing handrim speed. It is suggested that an ineffective direction of forces on the rims might (partly) be responsible for the low ME and for a decrease in ME in relation to tangential handrim velocity. This suggestion is discussed from a number of theoretical perspectives. It is concluded that the use of handrims with a lower mechanical advantage will increase wheelchair propulsion efficiency.

Within-cycle characteristics of the wheelchair push in sprinting on a wheelchair ergometer.

To investigate power output and torque production in wheelchair sprinting, six able-bodied subjects performed nine 20-s sprint tests on a stationary wheelchair ergometer (load 0-8 kg). Ergometer data were analyzed and combined with kinematic data and surface electromyography. Of all power and torque parameters investigated, only maximal power output was independent of load (mean peak value 375 W, one-sided). Mean power output is suggested to be a useful indicator for anaerobic power production, but test conditions concerned speed in relation to handrim diameter should be specified. The relevance of the "mechanical constraint principle" for handrim propulsion is discussed. Within one cycle, power and torque curves showed a negative deflection at the beginning and a valley approximately halfway through the push phase. The relation of these phenomena to kinematic parameters and muscle activity is discussed.

Wheelchair racing: effects of rim diameter and speed on physiology and technique.

Effects of different hand rim diameters in wheelchair racing were studied with respect to physiological and technique parameters at five speed levels (N = 8 wheelchair sportsmen). In each of five subsequent 15-min exercise tests on a treadmill, a different sized hand rim was mounted to the rear wheels (0.3, 0.35, 0.38, 0.47, 0.56 m). In each test, speed increased with 0.83 m.s-1 every 3 min, starting at 0.83 m.s-1 and ranging up to 4.17 m.s-1 (slope: 0.5 degrees). Cardiorespiratory responses (ventilation, oxygen cost, heart rate, respiratory exchange ratio, mechanical efficiency) and timing data (cycle time, push time, recovery time, push angle, and work per cycle) were obtained every 3rd min, together with the movement pattern of trunk and arm segments. Clear effects of rim diameter and speed were seen for the physiological parameters (P less than 0.05). In physiological terms, D5 appeared the least beneficial, followed by D4. Moreover, increasing rim diameter had a significant effect on movement pattern of the upper arm in the sagittal as well the frontal plane of motion. However, no timing effects were seen with changing rim diameter. On the other hand, timing parameters varied markedly with speed, whereas the segmental excursions of the upper limb did not show a "speed-effect". In general, small hand rims show lower cardiorespiratory responses. This may be related to the decreased segmental excursions of the upper limb and the lower linear hand velocity. Together with a low rolling and air drag, heart rate, and oxygen cost, these are important prerequisites in racing events.(ABSTRACT TRUNCATED AT 250 WORDS)

Manual wheelchair propulsion: effects of power output on physiology and technique.

Eight wheelchair sportsmen conducted eight wheelchair exercise tests on a treadmill. Two workload strategies were followed: strategy 1--increments in speed at a constant slope and strategy 2--increments in slope at constant velocity. Thus, data on cardio-respiratory and propulsion technique parameters were obtained on two identical series of 16 speed and slope combinations. Between each two identical speed and slope combinations of strategies 1 and 2, a different workload history is apparent. A four-factor analysis of variance with repeated measures on the factors "strategy" (workload history), "speed," and "slope" was applied (P less than 0.05). No "strategy" effect was seen in the cardio-respiratory parameters (gross mechanical efficiency, ventilation, oxygen consumption, and heart rate), work/cycle, and cycle time. Thus, within the experimental set-up, workload history did not affect the parameters studied and 3-min workload periods appeared sufficiently long for experienced wheelchair users to adapt to the requirements of a given speed and slope combination. Significant effects were found on "speed," "slope," and their interaction in all parameters tested. Moreover, a comparison of two equal levels of power output, but different speed and slope, led to a significantly higher efficiency, cycle time, and work per cycle for the "low speed and high slope" combination. Push time and recovery time appeared highly dependent on speed and slope, respectively. The findings indicate that propulsion technique and cardio-respiratory parameters should not merely be studied in relation to power output, but also with respect to its constituents, speed, and slope/resistance.

Parameters for modeling the upper extremity.

The purpose of this paper was to provide parameters for the development of a musculoskeletal model of the upper extremity. Five upper extremity specimens were obtained from four fresh cadavers. Anthropometric measures were obtained for each cadaver. Segment inertial parameters were estimated for each specimen from anthropometric measures of the cadaver from which the specimen was obtained. The three-dimensional kinematics of the humerus, ulna, and radius in different movements of the glenohumeral, humeroulnar and ulnoradial joints were measured for each specimen using of the 3Space tracking system (Isotrack, Polhemus). The instantaneous rotation center of the glenohumeral joint and the instantaneous rotation axes of elbow flexion and forearm pronation were determined for each specimen from the kinematic data. The specimens were dissected and the muscle origins and insertions and bony structures needed in upper extremity modeling were digitized using the 3Space system. The shapes of muscle origins and insertions were estimated. Muscle length, volume and pennation angle were measured for the estimation of physiological cross-sectional areas of each muscle. The results, which are given for one specimen, showed that the rotation center of the glenohumeral joint was very close to the geometric center of the joint with a mean distance of 4 mm. The mean angle between the flexion-extension and pro-supination axes of the elbow joint was 94 degrees. The minimum distance between these two axes was about 4 mm.

A three-dimensional muscle model: a quantified relation between form and function of skeletal muscles.

A three-dimensional muscle model with complex geometry is described and tested against experimental data. Using this model, several muscles were constructed. These muscles have equal optimum length but differ in architecture. The force exerted by the constructed muscles, in relation to their actual length and velocity of shortening, is discussed. Generally speaking, the constructed muscles with considerable pennation have great fiber angles, a great physiological cross section, a narrow active and steep passive length-force relation, and a low maximal velocity of shortening. The maximal power (force times velocity) delivered by the constructed muscles is shown to be almost independent of the architecture of the muscles. The steepness of the passive length-force relation is determined mainly by the shortest fibers within the group of constructed muscles, whereas maximal velocity of shortening and the width of the active length-force relation are determined mainly by the longest fibers. The validity of the three-dimensional muscle model with respect to some morphological and functional characteristics is tested. Length-force relations of constructed muscles are compared with the actual length-force relations of mm. gastrocnemii mediales and mm. semimembranosi of male Wistar rats. Moreover, actual fiber angle, fiber length, and muscle thickness of three mm. gastrocnemii mediales are compared with values found for constructed muscles. It is concluded that the three-dimensional muscle model closely approximates the actual muscle form and function.

Functional characteristics of the calf muscles of the rat.

Length-force relations, both active and passive, and twitch contraction characteristics were quantified for the entire complex of the superficial calf muscles, as well as individually for the Mm. soleus, plantaris, and gastrocnemius, caput mediale and laterale, of eight male Wistar rats. The M. soleus composes approximately 5% of the weight and cross-sectional area of the entire group of superficial calf muscles and is the only muscle of the group containing mainly slow-twitch fibers. The other superficial muscles of the calf are primarily fast-twitch muscles. The mono-articular M. soleus, the bi-articular M. gastrocnemius, caput mediale and laterale, and the poly-articular M. plantaris differ with respect to the number of joints crossed. However, contrary to the findings for cat hind limbs (Goslow et al. [1977] J. Morphol. 153:23-38), the muscles of the complex of superficial calf muscles of the rat did not differ with respect to a) their fiber optimum length, b) their maximum length range of active force generation, c) the relative increase of passive force owing to lengthening of the muscle, d) the angle of the ankle at which they produce maximal active force (the knee angle was fixed at 90 degrees).

Functional morphology of the M. gastrocnemius medialis of the rat during growth.

Length-force relations, both active and passive, and twitch contraction characteristics were quantified for left medial gastrocnemius muscles of four young, four adult, and four old male Wistar rats. Muscle and bundle optimum length and muscle weight were also determined and subsequently used for calculation of a number of morphological characteristics of the muscles. Fiber optimum length was derived from muscle bundle optimum length. Generally, physiological characteristics remained constant during growth. There was no change either in active tension at muscle optimum length or in active working range relative to fiber optimum length, relative passive fiber stiffness, active force relative to passive force at optimum length, twitch contraction time and twitch half relaxation time at optimum length. A number of morphological changes, however, did take place in the medial gastrocnemius muscle during growth. Fiber optimum length increased but only by about 2 mm from youth to old age, whereas muscle optimum length increased by approximately 14 mm, presumably owing to extensive hypertrophy of the muscle fibers during growth. The priority for force of the medial gastrocnemius muscle (defined as the quotient of physiological cross-sectional area of a muscle and the cubed root of its volume, a measure independent of architecture and dimensions of muscles) increased during growth. This increase indicates that during growth the muscle shifts relatively more towards force generation than towards excursion generation. These findings are discussed in view of existing scaling theories.

Inertia and muscle contraction parameters for musculoskeletal modelling of the shoulder mechanism.

To develop a musculoskeletal model of the shoulder mechanism, both shoulders of seven cadavers were measured to obtain a complete set of parameters. Using antropometric measurements, the mass and rotational inertia of segments were estimated, followed by three-dimensional measurements of all morphological structures relevant for modelling, i.e. muscle origins and insertions, muscle bundle directions, ligament attachments and articular surfaces; all in relation to selected bony landmarks. Subsequently, muscle contraction parameters as muscle mass and physiological cross-sectional area were measured. The method of data collection and the results for inertia and muscle contraction parameters as prerequisities for modelling are described.

Geometry parameters for musculoskeletal modelling of the shoulder system.

A dynamical finite-element model of the shoulder mechanism consisting of thorax, clavicula, scapula and humerus is outlined. The parameters needed for the model are obtained in a cadaver experiment consisting of both shoulders of seven cadavers. In this paper, in particular, the derivation of geometry parameters from the measurement data is described. The results for one cadaver are presented as a typical example. Morphological structures are modelled as geometrical forms. Parameters describing this form are estimated from 3-D position coordinates of a large number of datapoints on the morphological structure, using a least-squares criterion. Muscle and ligament attachments are represented as a plane or as a (curved) line. Muscle paths are determined by a geometrical form of the bony contour around which the muscle is wrapped. Muscle architecture is determined by the distribution of muscle bundles over the attachment area, mapping the distribution of the origin to the insertion. Joint rotation centers are derived from articular surfaces. Hence, muscle moment arms can be calculated. The result of this study is a set of parameters for each cadaver, describing very precisely the geometry of the shoulder mechanism. This set allows positioning of muscle force vectors a posteriori, and recalculation of position coordinates and moment arms for any position of the shoulder.

Reliability of phase-velocity measurements of tibial bone.

BACKGROUND AND PURPOSE: The Bone Stiffness Measurement Device-Swing is capable of measuring the propagation velocity of flexural waves in human tibial bone, which relates to bending stiffness. If the interrater and intrarater reliability of measurements obtained with the device are established, it can be used with confidence in assessing changes in bone. The purposes of this study were to detect potential sources of measurement error and to establish the interrater and intrarater reliability of measurements taken with the device. SUBJECTS AND METHODS: In the first part of the study, a random-effects design was used to obtain phase-velocity measurements in subjects without known orthopedic or neurological impairments. The second part of the study consisted of possible applications of the device with mixed designs on subjects with spinal cord injuries. By means of generalizability theory, multiple sources of error (eg, occasion, clinician, repetition) were estimated. For the clinical trial, 17 persons with spinal cord injuries not older than 5 weeks were tested. RESULTS: The standard error of measurement (SEM) for intrarater reliability measurements ranged from 7.3 to 9.8 m x s(-1) . The SEMs for interrater reliability measurements ranged from 5.7 to 9.5 m x s(-1). The SEMs for measurements obtained by a single clinician in a clinical population ranged from 11.9 to 39.7 m x s(-1). CONCLUSION AND DISCUSSION: The reproducibility of measurements obtained with the device is suitably high for the device to be used for evaluation in clinical and research settings.

Load on the upper extremity in manual wheelchair propulsion.

To study joint contributions in manual wheelchair propulsion, we developed a three-dimensional model of the upper extremity. The model was applied to data collected in an experiment on a wheelchair ergometer in which mechanical advantage (MA) was manipulated. Five male able-bodied subjects performed two wheelchair exercise tests (external power output P(ext) = 0.25-0.50 W · kg(-1)) against increasing speeds (1.11-1.39-1.67 m.s(-1)), which simulated MA of 0.58-0.87. Results indicated a decrease in mechanical efficiency (ME) with increasing MA that could not be related to applied forces or joint torques. Increase in P(ext) was related to increases in joint torques. On the average, the highest torques were noted in shoulder flexion and adduction (35.6 and 24.6 N · m at MA = 0.58 and P(ext)= 0.50 W · kg(-1)). Peak elbow extension and flexion torques were -10.6 and 8.5 N · m. Based on the combination of torques and electromyographic (EMG) records of upper extremity muscles, anterior deltoid and pectoralis muscles are considered the prime movers in manual wheelchair propulsion. Coordinative aspects of manual wheelchair propulsion concerning the function of (biarticular) muscles in directing the propulsive forces and the redistribution of joint torques in a closed chain are discussed. We found no conclusive evidence for the role of elbow extensors in direction of propulsive forces.

Orientation of the scapula in a simulated wheelchair push.

For a systematic study of the efficiency of manual wheelchair propulsion, biomechanical and functional analysis of the wheelchair push is necessary. Recently a three-dimensional (simulation) model of the shoulder mechanism has been developed. For a complete analysis with this model, information on force and kinematics is needed. To determine the three-dimensional orientations of the scapula during wheelchair propulsion static measurements in different phases of the push (-15, 0, 15, 30, and 60) relative to the vertical through the wheel axis) and against different loads (0, 10, 20, 30 and 40% of the maximal torque) have been performed. Scapular rotations were generally small and correlated poorly with net torque on the glenohumeral joint. On the basis of the measurements of thoracal and humeral orientation and net torque, equations have been formulated which can be used to describe the scapular orientation during actual wheelchair propulsion. Its consequences and applicability are discussed.

The effect of rear wheel camber in manual wheelchair propulsion.

Eight nonimpaired subjects participated in a wheelchair exercise test using a motor-driven treadmill in order to study the effect of rear wheel camber on wheelchair ambulation. The test consisted of four runs with rear wheels in 0, 3, 6, and 9 degrees camber at four speed steps of 2, 3, 4, and 5 km/hr. There were no significant effects upon oxygen cost, heart rate, and mechanical efficiency. The kinematic parameters of push time, push angle, and abduction showed differences between 3 and 6 degrees camber. The relationship between the findings, using surface EMG results for six shoulder muscles, is discussed. For one subject, data were extended to study the angular velocities of shoulder and elbow.

Seat height in handrim wheelchair propulsion.

To study the effect of seat height on the cardiorespiratory system and kinematics in handrim wheelchair ambulation, nine non-wheelchair users participated in a wheelchair exercise experiment on a motor-driven treadmill. The subjects conducted five progressive exercise tests. After an initial try-out test, four tests were performed at different standardized seat heights of 100, 120, 140, and 160 degrees elbow extension (subject sitting erect, hands on the rim in top-dead-center = 12.00 hrs; full extension = 180 degrees). Each test consisted of four 3-minute exercise blocks at speeds of respectively 0.55, 0.83, 1.11, and 1.39 m.s-1 (2-5 km.hr-1). Analysis of variance revealed significant effects of seat height (P less than 0.05) on gross mechanical efficiency (ME), oxygen cost, push range, and push duration, and on the ranges of motion in the different arm segments and trunk. Mean ME appeared higher at the lower seat heights of 100 and 120 degrees elbow extension. This is reflected in an enhanced oxygen consumption at seat heights of 140 and 160 degrees elbow extension. Simultaneously, the push range showed a 15 to 20 degree decrease with increasing seat height, which is reflected in a decreased push duration. In the push phase, decreases in retroflexion and abduction/adduction of the upper arm were seen. The trunk shifted further forward, and the motion range in the elbow joint shifted to extension with increasing seat height. No shifts in minimum and maximum angular velocities were seen with increasing seat height. The results showed an interrelationship between wheelchair seat height and both cardiorespiratory and kinematic parameters. With respect to the cardiorespiratory system, the optimization of the wheelchair geometry, based on functional characteristics of the user, appears beneficial.

Propulsion technique in hand rim wheelchair ambulation.

Six male subjects took part in a pilot study on a stationary wheelchair ergometer. They propelled the ergometer at a speed of 0.55, 0.83, 1.11 and 1.39 m/s. The speed increased every 3 min. Inertia and friction force were adjusted proportional to body weight. Every third minute 750 samples of the torque and velocity signals were digitized at a sampling rate of 100 Hz. From the signals mean external power output (Pmean), peak power (Ppeak), mean torque (Mmean) and peak torque (Mpeak), work/cycle, 'time-to-peak torque' (TTP), cycle duration (CT), push time (PT) and recovery time (RT) were determined in relation to mean velocity (speed). For the mean velocity range studied, analysis of variance (P less than 0.05) revealed significant increments in Ppeak, Mpeak, Pmean, Mmean and work/cycle with increasing mean velocity, whereas CT and PT showed a significant decrease. TTP showed a decrease with speed which, however, was not statistically significant. The RT showed no significant variation as well. Our previous research into propulsion techniques mainly focused on movement frequency and timing and was conducted during wheelchair ambulation on a motor driven treadmill. Despite considerable interindividual variation in terms of movement pattern, current and previous studies showed similar trends in the timing pattern (cycle, push, recovery duration) with respect to speed. Theoretical considerations regarding variations in peak torque and work/cycle with respect to velocity are supported by the current results. Both torque and work/cycle are important technique parameters and of relevance in speed regulation. The data also suggest that wheelchair ambulation can be validly simulated and studied with the special purpose wheelchair ergometer.(ABSTRACT TRUNCATED AT 250 WORDS)

Physiological evaluation of a newly designed lever mechanism for wheelchairs.

Lever-propelled wheelchairs have been described as more efficient and less physically demanding than hand-rim-propelled wheelchairs. To evaluate a newly designed lever mechanism (MARC) in both one- and two-arm use, a series of wheelchair exercise tests were performed on a motor-driven treadmill. Eight able-bodied male subjects performed a standard exercise test in the prototype MARC, both in an asynchronic and a synchronic bimanual propelling mode and in an unilateral (left-sided) mode. Subsequently the subjects performed additional exercise tests in a conventional crank-to-rod lever mechanism with unilateral and bimanual propulsion and in a conventional hand rim wheelchair. Analysis of variance was used to study the effect of the different work modes upon power output and cardiorespiratory parameters statistically (p < 0.05). The MARC stood out well in comparison with the conventional lever design. The additional design features which are to be implemented (variable gearing, reverse gear) will make the MARC a useful wheelchair. One-arm wheelchair propulsion is a very strenuous form of locomotion, requiring careful consideration in terms of provision. Mechanical and ergonomic improvements are quite feasible in lever propulsion and may to a certain extent reduce this problem. To improve overall mobility of wheelchair-dependent subjects further, ergonomic and mechanical design improvements are very necessary in lever as well as hand-rim wheelchairs. A combined biomechanical and physiological research approach will help in the definition of design criteria and fitting guidelines.

Physical strain and mechanical efficiency in hubcrank and handrim wheelchair propulsion.

The physical strain and mechanical efficiency of manual wheelchair propulsion using handrim and hubcrank propelled racing wheelchairs were studied during a submaximal wheelchair exercise test on a stationary roller ergometer. Ten healthy male able-bodied subjects conducted two exercise tests in a random order and measurements of phyical strain (oxygen uptake, minute ventilation, respiratory exchange ratio, heart rate) and gross mechanical efficiency were obtained. During the experiment torque data, speed and power output were determined at a sample frequency of 0.1 Hz. Analysis of variance for repeated measures (p < 0.05) was used to establish differences. The hubcrank propulsion mechanism showed a significantly lower physical strain and higher gross mechanical efficiency in comparison with the handrim propulsion mechanism. The lower strain and higher efficiency in propelling the hubcrank partly seems to be due to the continuous biphasic cyclic propulsion movement, which allows both push and pull forces to be exerted. This involves flexor and extensor muscles around elbow and shoulder, leading to a reduced tendency to fatigue in individual muscles in the upper extremity. The more natural and neutral wrist-hand orientation also seems to diminish finger flexor activity and wrist-stabilizing muscle activity, and will thus reduce physical strain both with respect to the cardiorespiratory and musculoskeletal systems. The latter may influence the tendency to develop carpal tunnel problems positively. The reduced strain of the hubcrank propulsion mechanism clearly has a number of advantages over handrims for the human engine in the short and long run. However, technical innovation should address current practical problems of steering and braking. Clearly, hubcranks can be used in low-seated wheelchairs (i.e. racing wheelchairs) only, and in subjects with a sufficiently large range of motion in the upper extremity. Moreover, the increased width is a drawback of hubcranks. Care should be taken while negotiating door posts.

Pregnant women and working surface height and working surface areas for standing manual work.

Physically loading aspects of work may have adverse effects on the health of both the pregnant woman and the unborn child. Improving the fit between the pregnant woman and the workplace layout contributes to minimizing the load associated with given tasks. The aim of this paper is to evaluate two layout aspects for standing manual work, namely working surface height and working surface areas, for the condition of pregnancy. Two approaches were used. (1) The effects of changed body dimensions were evaluated with regard to (a) fit problems while working at a workplace in accordance with common guidelines and (b) the validity of assumptions of these guidelines. (2) The appreciation of relevant aspects of workplace layout at a specific manual task was assessed. Twenty-seven women were examined in pregnant and non-pregnant conditions. The first approach showed that fit problems are likely: guideline working surface height is just (2-7 cm) under the most protruding abdominal point, and areas based on non-pregnant abdominal depth are relatively large in pregnant condition. Further, existing methods to assess working surface areas have various assumptions that are not valid in pregnant condition. The second approach showed that at a specific manual task, women in late pregnancy preferred a considerably lower table height than the common guideline heights. Possibly, abdominal height becomes a relevant design factor with regard to working surface height during pregnancy. The task position on the working surface at which effort started became closer to the table edge due to pregnancy. Both approaches show that common guideline working surface heights for manual work, and working surface areas assessed in non-pregnant condition seem not suitable in pregnant condition.

Twitch characteristics in relation to muscle architecture and actual muscle length.

The length dependence of twitch time characteristics is quantified for several skeletal muscles of the rat: lateral gastrocnemius, medial gastrocnemius, plantaris, soleus and semimembranosus. It is shown that muscle architecture influences the length dependent behaviour of twitch time characteristics of muscles. Twitch contraction time is less susceptible to length changes of the muscles than the twitch relaxation time. With the exception of the relaxation time in the second part of the relaxation, the twitch time characteristics behave different with respect to their dependence on fibre length, in fact muscles that differ in architecture. It is concluded that twitch time characteristics are dependent on the actual muscle length and therefore should be determined at a well defined length.