Effects of Daily Physical Activity Level on Manual Wheelchair Propulsion Technique in Full-Time Manual Wheelchair Users During Steady-State Treadmill Propulsion.

OBJECTIVE: To examine whether differences in propulsion technique as a function of intraindividual variability occur as a result of shoulder pain and physical activity (PA) level in full-time manual wheelchair users (MWUs). DESIGN: Observational study. SETTING: Research laboratory. PARTICIPANTS: Adults (N=14) with spinal cord injury (mean age: 30.64±11.08) who used a wheelchair for >80% of daily ambulation and were free of any condition that could be worsened by PA. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: PA level was measured using the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), and shoulder pain was measured using the Wheelchair User's Shoulder Pain Index (WUSPI) survey. Mean and intraindividual variability propulsion metrics were measured for propulsion analysis. RESULTS: WUSPI scores indicated participants experienced low levels of shoulder pain. The results of the Spearman rank-order correlation revealed that PASIPD scores were significantly related to mean contact angle (rs=-.57) and stroke frequency (rs=.60) as well as to coefficient of variation of peak force (rs=.63), peak torque (rs=.59), contact angle (rs=.73), and stroke frequency (rs=.60). WUSPI scores were significantly correlated with only mean peak force (P=.02). No significant correlations were observed between PASIPD, WUSPI, and body mass index scores. CONCLUSIONS: Differences in propulsion technique were observed on the basis of PA levels. Participants with higher PASIPD scores used a more injurious stroke technique when propelling at higher speeds. This may indicate that active individuals who use injurious stroke mechanics may be at higher risk of injury. A strong relation was found between peak propulsion forces and shoulder pain. Rehabilitation professionals should emphasize the use of a protective stroke technique in both inactive and active MWUs during exercise and faster propulsion.

Short-term influence of transfer training among full time pediatric wheelchair users: A randomized trial.

OBJECTIVE/BACKGROUND: To describe a structured, short-term, transfer training intervention for full-time pediatric wheelchair users, investigate the impact of training on transfer skills, and to examine similarities and differences in response to training compared to those seen in adult wheelchair users. DESIGN: Randomized clinical trial. METHODS: Participants were first randomized into an intervention (IG) or control group (CG). After completing surveys and demographic intake forms, all participants performed two sets of level transfers (from wheelchair to bench and back to wheelchair = one set) at three time points. Each time point composed of two transfer sets were scored using the Transfer Assessment Instrument (TAI) and averaged to produce a final transfer score per time point. No feedback or training were given to participants prior to time points one and two however the IG received structured training prior to transfer assessment # 3. TAI scores were compared at transfer assessment #3 using a Mann-Whitney test. OUTCOME MEASURES: Transfer Assessment Instrument (TAI) and Self-Perception Profile for Children (SPPC). RESULTS: Intervention group participants demonstrated significant improvements among TAI scores (9.06 ± 1.01) compared to the control group (7.15 ± 1.67), P = 0.030, d = 1.385. No significant differences were found among SPPC scores. CONCLUSION: Pediatric wheelchair users transfer skills were found to improve immediately after training with TAI score changes similar to those seen in adult wheelchair users after training. Such improvements may be a factor in long-term upper extremity preservation. Further testing is needed to examine the long-term impact of improved transfer skills.

Influence of handrim wheelchair propulsion training in adolescent wheelchair users, a pilot study.

Ten full-time adolescent wheelchair users (ages 13-18) completed a total of three propulsion trials on carpet and tile surfaces, at a self-selected velocity, and on a concrete surface, at a controlled velocity. All trials were performed in their personal wheelchair with force and moment sensing wheels attached bilaterally. The first two trials on each surface were used as pre-intervention control trials. The third trial was performed after receiving training on proper propulsion technique. Peak resultant force, contact angle, stroke frequency, and velocity were recorded during all trials for primary analysis. Carpet and tile trials resulted in significant increases in contact angle and peak total force with decreased stroke frequency after training. During the velocity controlled trials on concrete, significant increases in contact angle occurred, as well as decreases in stroke frequency after training. Overall, the use of a training video and verbal feedback may help to improve short-term propulsion technique in adolescent wheelchair users and decrease the risk of developing upper limb pain and injury.

The influence of officer equipment and protection on short sprinting performance.

As advances in protective equipment are made, it has been observed that the weight law enforcement officers must carry every day is greatly increasing. Many investigations have noted the health risks of these increases, yet none have looked at its effects on officer mobility. The primary purpose of this study was to examine the influence of both the weight of officer safety equipment, as well as a lateral focal point (FP), on the stride length, stride velocity, and acceleration of the first six strides of a short sprint. Twenty male law enforcement students performed two maximal effort sprint trials, in the participating college's gymnasium, from each of four starting positions: forwards (control position), backwards, 90° left, and 90° right. Subjects placed in the FP group (n = 9) were required to maintain focus on lateral FP during the 90° left and 90° right trials, and a forwards FP during the backwards trials. On a second testing date, subjects repeated the sprint tests while wearing a 9.07 kg weight belt, simulating officer equipment and protective gear. The belt averaged 11.47 ± 1.64% of subject body mass. A significant main effect of weight belt trials was found (F = 20.494, p < 0.01), in which significant decreases were found for velocity and acceleration. No other significant effects were found as a result of starting position or focal point and no significant interactions were found between independent variables. Conclusively, the results of this study show the increasing weights of duty gear and protective equipment have detrimental effects on officer velocity and acceleration, impeding their mobility, which may be dangerous in use of force or threatening situations.