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Abou L, Rice LA. The differences in demographics, fear of falling, transfer quality and participation enfranchisement between manual and power wheelchair users with multiple sclerosis and spinal cord injury. Disabil Rehabil Assist Technol 2024; 19:1003-1008. [PMID: 36301722 DOI: 10.1080/17483107.2022.2138998] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/31/2022] [Accepted: 10/17/2022] [Indexed: 10/31/2022]
Abstract
PURPOSE To examine the differences in demographics, fear of falling (FOF), transfer quality and participation enfranchisement between manual and power wheelchair users with multiple sclerosis (MS) and spinal cord injury (SCI). MATERIALS AND METHODS Secondary data analysis including 126 manual or power wheelchair users with MS and SCI (median age, 53.00 years, IQR = 24.00). Demographic information including age, gender, height, weight and disability duration was collected. Body mass index (BMI) was calculated for all participants. Participation enfranchisement was examined using both subscales (Importance and Control) of the enfranchisement scale of the Community Participation Indicator (CPI). FOF was assessed using the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) and transfer quality was assessed using the Transfer Assessment Instrument (TAI) 3.0 and 4.0. Mann-Whitney's U-tests or independent samples t-tests and chi-square were used to analyse the differences between continuous variables and categorical variables, respectively. RESULTS Fifty-seven percent of participants were manual wheelchair users. There were significant differences in most demographic information except for weight and disability duration. Significant differences were also found for BMI (t = 1.06, p = 0.04), CPI-Importance (U = 1282.50, p < 0.01), CPI-Control (U = 1165.50, p < 0.01) and SCI-FCS (t = 4.08, p < 0.01). Manual wheelchair users outperformed power wheelchair users in all outcomes analysed except the TAI (p = 0.18). CONCLUSIONS Power wheelchairs users presented with a higher BMI, reported lower participation enfranchisement, and reported higher levels of FOF compared to manual wheelchair users. The findings may help clinicians to develop targeted rehabilitation goals specific for power and manual wheelchair users with MS and SCI.
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Affiliation(s)
- Libak Abou
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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2
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Flockhart EW, Miller WC, Campbell JA, Mattie JL, Borisoff JF. Evaluation of two power assist systems for manual wheelchairs for usability, performance and mobility: a pilot study. Disabil Rehabil Assist Technol 2023; 18:1290-1302. [PMID: 34807781 DOI: 10.1080/17483107.2021.2001063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Power-assist devices for manual wheelchairs offer benefits, including increased community participation. Several power-assist devices are commercially available, but research on benefits and limitations of devices is limited. OBJECTIVE To compare the usability, performance, and mobility of two power-assist device systems for manual wheelchairs in indoor and outdoor environments. METHODS This mixed methods pilot study included 11 volunteers with limited wheelchair experience. Participants tested two different power-assist device configurations: (1) the Batec® and (2) the SmartDrive® + Freewheel®. Indoor & outdoor obstacle courses contained relevant skills from the Wheelchair Skills Test, Power Mobility Community Driving Assessment, and Power Mobility Indoor Driving Assessment. The NASA Task Load Index and System Usability Scale assessed participants' perceptions of cognitive demand and usability. A semi-structured interview was conducted to explore participants' experiences. RESULTS Substantial differences were found in the NASA Task Load Index, and System Usability Scale scores. Participant interviews and researcher observations revealed each device performed better on some obstacle course elements. Qualitative findings showed a general preference for using the Batec® for long trips outside and off-road terrains, primarily due to the Batec's® perceived better speed control, maximum speed, and simpler braking system. Conversely, the SmartDrive® + Freewheel® was deemed most useful indoors and in tight spaces; due to a smaller wheelchair footprint, better turning radius, and increased device portability. CONCLUSION Further studies are required to understand the usability, performance, and mobility of power-assist devices. Moving forward, these findings will inform end users and occupational therapists when procuring manual wheelchair power-assist devices.Implications for rehabilitationPower-assist devices (PADs) for manual wheelchairs increase the potential for community participation.Qualitative findings showed a general preference for using the Batec® for long trips outside and for off-road terrains, primarily due to the Batec's® perceived better speed control, maximum speed, and simpler braking system.The SmartDrive® + Freewheel® was deemed most useful indoors and in tight spaces; due to a smaller wheelchair footprint, better turning radius, and increased device portability.Increasing knowledge and research about PADs will support development of alternative options for manual or power wheelchairs users. PADs may allow manual wheelchair users (MWC) to delay moving to a power wheelchair (PWC), potentially reducing the perceived stigma associated with transitioning to a power wheelchair and impacting health outcomes.
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Affiliation(s)
- Elliott W Flockhart
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - William C Miller
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Jory A Campbell
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Johanne L Mattie
- MAKE+, British Columbia Institute of Technology, Burnaby, Canada
| | - Jaimie F Borisoff
- Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
- International Collaboration on Repair Discoveries, Vancouver, Canada
- Canada Research Chair in Rehabilitation Engineering Design, British Columbia Institute of Technology, Burnaby, Canada
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Pradon D, Garrec E, Vaugier I, Weissland T, Hugeron C. Effect of power-assistance on upper limb biomechanical and physiological variables during a 6-minute, manual wheelchair propulsion test: a randomised, cross-over study. Disabil Rehabil 2022; 44:6783-6787. [PMID: 34546807 DOI: 10.1080/09638288.2021.1973586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Use of a power-assistance wheelchair could reduce the risk of musculoskeletal disorders (MSDs), however, a comprehensive biomechanical evaluation of these systems has not been carried out. This study aimed to evaluate and compare biomechanical UL propulsion variables, and physiological exercise-related variables during the use of a wheelchair with rear drive power assist device (RD-PAD) and a standard manual wheelchair (MW). MATERIALS AND METHODS Twenty-two adults with spinal cord injury were recruited. RD-PAD (SmartDrive system) was fitted to their own MW. An instrumented wheel was used to measure handrim forces, and gas exchange and heart rate were monitored. Participants performed repeated out and back runs for 6 min on a straight outdoor course. RESULTS Distance covered was significantly greater with the RD-PAD (538 ± 104 m versus 470 ± 124 m). Peak mechanical effort during the propulsion phase was significantly lower with the RD-PAD (p < 0.001). Heart rate, metabolic equivalent of task (MET), tidal volume, minute volume, oxygen consumption, and peak oxygen consumption were all significantly lower with the RD-PAD (p < 0.001). CONCLUSIONS The results showed that use of RD-PAD increased the distance covered by MW users and reduced the energy costs of propulsion. The biomechanical results indirectly suggest that RD-PAD may reduce the risk of MSD.Implications for RehabilitationUsing the SmartDrive system as propulsion assistance increases the travel autonomy.The SmartDrive system reduces the biomechanical constraints propelling the wheelchair on a slope and low slope.SmartDrive the system reduces the physiological solicitation related to the propulsion of wheelchair.
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Affiliation(s)
- Didier Pradon
- UMR 1179 End:icap, INSERM UVSQ, Garches, France.,CHU Raymond Poincaré APHP, Garches, France.,ISPC-Synergies, Garches, France
| | - Elodie Garrec
- UMR 1179 End:icap, INSERM UVSQ, Garches, France.,CHU Raymond Poincaré APHP, Garches, France.,Fondation Garches, Garches, France
| | - Isabelle Vaugier
- CHU Raymond Poincaré APHP, Garches, France.,CIC 1429 INSERM APHP, Garches, France
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Jahanian O, Gaglio A, Cho CC, Muqeet V, Smith R, Morrow MMB, Hsiao-Wecksler ET, Slavens BA. Hand-rim biomechanics during geared manual wheelchair propulsion over different ground conditions in individuals with spinal cord injury. J Biomech 2022; 142:111235. [PMID: 35947887 PMCID: PMC10765479 DOI: 10.1016/j.jbiomech.2022.111235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022]
Abstract
Geared manual wheelchair wheels, a recently developed alternative propulsion mechanism, have the potential to alleviate the high upper extremity demands required for wheelchair propulsion and help decrease the risk of secondary injuries in manual wheelchair users. The objective of this study was to investigate the effects of using geared manual wheelchairs on hand-rim biomechanics of wheelchair propulsion in individuals with spinal cord injury (SCI). Seven manual wheelchair users with SCI propelled their wheelchairs equipped with geared wheels over tile, carpet, and up a ramp in low gear (gear ratio 1.5:1) and standard gear (gear ratio 1:1) conditions. Hand-rim kinetics and stroke cycle characteristics were measured using a custom instrumented geared wheel. Using the geared wheels in the low gear condition, propulsion speed (P = 0.013), peak resultant force (P = 0.005), peak propulsive moment (P < 0.006), and peak rate of rise of the resultant force (P = 0.035) decreased significantly in comparison with the standard gear condition. The significant increase in the number of stroke cycles when normalized to distance (P = 0.004) and decrease in the normalized integrated moment (P = 0.030) indicated that although a higher number of stroke cycles are required for travelling a given distance in the low gear than the standard gear condition, the low gear condition might be less demanding for the upper extremity. These results suggest that geared wheels could be a useful technology for manual wheelchair users to independently accomplish strenuous propulsion tasks including mobility on carpeted floors and ramp ascension, while reducing the risk factors contributing to the incidence of secondary upper extremity injuries.
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Affiliation(s)
- Omid Jahanian
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
| | - Alan Gaglio
- Department of Mechanical Science & Engineering, University of Illinois at Urbana-Champaign, IL, USA
| | - Chris C Cho
- College of Health Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Vaishnavi Muqeet
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Roger Smith
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Melissa M B Morrow
- Department of Nutrition, Metabolism & Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Brooke A Slavens
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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5
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Chénier F, Alberca I, Gagnon DH, Faupin A. Impact of Sprinting and Dribbling on Shoulder Joint and Pushrim Kinetics in Wheelchair Basketball Athletes. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:863093. [PMID: 36189044 PMCID: PMC9397776 DOI: 10.3389/fresc.2022.863093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022]
Abstract
Background While wheelchair basketball is one of the most popular Paralympic sports, it eventually causes shoulder problems and pain in many athletes. However, shoulder kinetics has never been assessed during propulsion in wheelchair basketball. This study analyzes the impact of sprinting and dribbling on pushrim and shoulder kinetics in terms of external forces and net muscular moments. Methods A group of 10 experienced wheelchair basketball athletes with various classifications performed four, 9-m sprints on a basketball court using classic synchronous propulsion, and four sprints while dribbling forward. Pushrim and shoulder kinetics were calculated by inverse dynamics, using a motion capture device and instrumented wheels. Findings Sprinting was associated to peak shoulder load from 13 to 346% higher than in previous studies on standard wheelchair propulsion in most force/moment components. Compared to sprinting without a ball, dribbling reduced the speed, the peak external forces in the anterior and medial direction at the shoulder, and the peak net shoulder moment of internal rotation. Interpretation The high shoulder load calculated during both sprinting and dribbling should be considered during training sessions to avoid overloading the shoulder. Dribbling generally reduced the shoulder load, which suggests that propelling while dribbling does not put the shoulder at more risk of musculoskeletal disorders than sprinting.
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Affiliation(s)
- Félix Chénier
- Mobility and Adaptive Sports Research Lab, Department of Physical Activity Science, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
- *Correspondence: Félix Chénier
| | - Ilona Alberca
- Université de Toulon, Impact de l'Activité Physique sur la Santé (UR IAPS n°201723207F), Campus de La Garde, Toulon, France
| | - Dany H. Gagnon
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, QC, Canada
- School of Rehabilitation, Université de Montréal, Faculty of Medicine, Montreal, QC, Canada
| | - Arnaud Faupin
- Université de Toulon, Impact de l'Activité Physique sur la Santé (UR IAPS n°201723207F), Campus de La Garde, Toulon, France
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Jahanian O, Schnorenberg AJ, Muqeet V, Hsiao-Wecksler ET, Slavens BA. Glenohumeral joint dynamics and shoulder muscle activity during geared manual wheelchair propulsion on carpeted floor in individuals with spinal cord injury. J Electromyogr Kinesiol 2022; 62:102318. [PMID: 31178393 PMCID: PMC6885114 DOI: 10.1016/j.jelekin.2019.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/08/2019] [Accepted: 05/30/2019] [Indexed: 02/03/2023] Open
Abstract
This study investigated the effects of using geared wheels on glenohumeral joint dynamics and shoulder muscle activity during manual wheelchair propulsion. Seven veterans with spinal cord injury propelled their wheelchairs equipped with geared wheels over a carpeted floor in low gear (1.5:1) and standard gear (1:1) conditions. Hand-rim kinetics, glenohumeral joint dynamics, and muscle activity were measured using a custom instrumented geared wheel, motion analysis, and surface electromyography. Findings indicated that the propulsion speed and stroke distance decreased significantly during the low gear condition. The peak hand-rim resultant force and propulsive moment, as well as the peak glenohumeral inferior force and flexion moment, were significantly less during the low gear condition. The peak and integrated muscle activity of the anterior deltoid and pectoralis major decreased significantly, while the normalized integrated muscle activity (muscle activity per stroke distance) was not significantly different between the two conditions. Propulsion on carpeted floor in the low gear condition was accompanied by a reduced perception of effort. The notable decrease in the peak shoulder loading and muscle activity suggests that usage of geared wheels may be beneficial for wheelchair users to enhance independent mobility in their homes and communities while decreasing their shoulder demands.
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Affiliation(s)
- Omid Jahanian
- Department of Occupational Science and Technology, University of Wisconsin–Milwaukee, Milwaukee, WI, USA
| | - Alyssa J Schnorenberg
- Department of Occupational Science and Technology, University of Wisconsin–Milwaukee, Milwaukee, WI, USA
| | - Vaishnavi Muqeet
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Brooke A. Slavens
- Department of Occupational Science and Technology, University of Wisconsin–Milwaukee, Milwaukee, WI, USA,Department of Biomedical Engineering, University of Wisconsin–Milwaukee, Milwaukee, WI, USA
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7
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Comparison of Manual Wheelchair and Pushrim-Activated Power-Assisted Wheelchair Propulsion Characteristics during Common Over-Ground Maneuvers. SENSORS 2021; 21:s21217008. [PMID: 34770323 PMCID: PMC8587423 DOI: 10.3390/s21217008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/25/2022]
Abstract
Pushrim-activated power-assisted wheels (PAPAWs) are assistive technologies that use force sensor data to provide on-demand propulsion assistance to manual wheelchair users. However, available data about kinetic and kinematic of PAPAW use are mainly limited to experiments performed on a treadmill or using a dynamometer. In this work, we performed experiments to gather kinetics of wheelchair propulsion and kinematics of wheelchair motion for a variety of over-ground wheelchair maneuvers with a manual wheelchair with and without PAPAWs. Our findings revealed that using PAPAWs can significantly reduce the propulsion effort and push frequency. Both linear and angular velocities of the wheelchair were significantly increased when using PAPAWs. Less force and push frequency could potentially reduce risk of chronic upper limb injury. Higher linear velocity could be desirable for various daily life activities; however; the increase in the angular velocity could lead to unintended deviations from a desired path. Future research could investigate PAPAW controllers that amplify the desired intentions of users while mitigating any unwanted behaviours.
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8
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Khalili M, Eugenio A, Wood A, Van der Loos M, Mortenson WB, Borisoff J. Perceptions of power-assist devices: interviews with manual wheelchair users. Disabil Rehabil Assist Technol 2021:1-11. [PMID: 33904351 DOI: 10.1080/17483107.2021.1906963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
PURPOSE The study had three main objectives. (1) To investigate the perceived impact of power-assist devices (PADs) on manual wheelchair (MWC) user mobility. (2) To compare perceptions about different types of PADs. (3) To identify preferred features and design characteristics of PADs. METHODS Semi-structured interviews were conducted with community-dwelling MWC users aged 31 years and older, with at least 2.5 years of experience using an MWC independently (n = 16). Data were thematically analysed using an inductive approach. RESULTS Two main themes related to participants' perceptions about the effects of PAD use were identified: (1) "Expanding my world", which illustrated the perceived benefits of using PADs (e.g., gaining a sense of autonomy and access to new environments, maintaining physical health) and (2) "Falling short", which described challenges with PADs (e.g., safety, reliability and portability issues). Participants also identified strengths and limitations of different types of PADs that were mainly related to specific user-device and device-environment interactions as well as various functional characteristics. Moreover, participants outlined their priorities for future PAD design, including improving controllability, customizability and affordability of these devices. CONCLUSIONS Participants' perceptions about PADs varied across different types of devices and in different contexts. However, PADs were generally perceived as enhancing the capabilities of MWCs. Our findings provide insight into the factors that can be considered when selecting a PAD and can inform the development of future PADs that are better equipped to overcome challenges that MWC users frequently encounter.Implications for RehabilitationPower-assist devices (PADs) for manual wheelchairs (MWCs) have the potential to improve the mobility, community participation and well-being of users.Some of the existing PADs have safety and reliability issues that affect their performance and limit their use by MWC users.The three types of PADs (front-mounted attachments, rear-mounted attachments, powered wheels) offer different types of assistance that can benefit users with various capabilities.
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Affiliation(s)
- Mahsa Khalili
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Angela Eugenio
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Allison Wood
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Machiel Van der Loos
- Department of Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.,International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Jaimie Borisoff
- International Collaboration on Repair Discoveries, Vancouver, BC, Canada.,British Columbia Institute of Technology, Vancouver, BC, Canada
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van der Woude LHV, Houdijk HJP, Janssen TWJ, Seves B, Schelhaas R, Plaggenmarsch C, Mouton NLJ, Dekker R, van Keeken H, de Groot S, Vegter RJK. Rehabilitation: mobility, exercise & sports; a critical position stand on current and future research perspectives. Disabil Rehabil 2020; 43:3476-3491. [PMID: 32805152 DOI: 10.1080/09638288.2020.1806365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Human movement, rehabilitation, and allied sciences have embraced their ambitions within the cycle of "RehabMove" congresses over the past 30 years. This combination of disciplines and collaborations in the Netherlands has tried to provide answers to questions in the fields of rehabilitation and adapted sports, while simultaneously generating new questions and challenges. These research questions help us to further deepen our understanding of (impaired) human movement and functioning, with and without supportive technologies, and stress the importance of continued multidisciplinary (inter)national collaboration. METHODS This position stand provides answers that were conceived by the authors in a creative process underlining the preparation of the 6th RehabMove Congress. RESULTS The take-home message of the RehabMove2018 Congress is a plea for continued multidisciplinary research in the fields of rehabilitation and adapted sports. This should be aimed at more individualized notions of human functioning, practice, and training, but also of performance, improved supportive technology, and appropriate "human and technology asset management" at both individual and organization levels and over the lifespan. CONCLUSIONS With this, we anticipate to support the development of rehabilitation sciences and technology and to stimulate the use of rehabilitation notions in general health care. We also hope to help ensure a stronger embodiment of preventive and lifestyle medicine in rehabilitation practice. Indeed, general health care and rehabilitation practice require a healthy and active lifestyle management and research agenda in the context of primary, secondary, and tertiary prevention.IMPLICATIONS FOR REHABILITATIONContinued multidisciplinary (international) collaboration will stimulate the development of rehabilitation and human movement sciences.Notions from "human and technology asset management and ergonomics" are fundamental to rehabilitation practice and research.The rehabilitation concept will further merge into general health care and the quality there-off.
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Affiliation(s)
- Lucas H V van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Han J P Houdijk
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Research & Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands
| | - Thomas W J Janssen
- Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands.,Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Research Institute MOVE, VU University, Amsterdam, The Netherlands
| | - Bregje Seves
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Reslin Schelhaas
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Corien Plaggenmarsch
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Noor L J Mouton
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rienk Dekker
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Helco van Keeken
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center, Amsterdam, The Netherlands.,Faculty of Behavioural and Movement Sciences, Department of Human Movement Sciences, Research Institute MOVE, VU University, Amsterdam, The Netherlands
| | - Riemer J K Vegter
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Bloomer C, Wang S, Kontson K. Kinematic analysis of motor learning in upper limb body-powered bypass prosthesis training. PLoS One 2020; 15:e0226563. [PMID: 31978051 PMCID: PMC6980621 DOI: 10.1371/journal.pone.0226563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/28/2019] [Indexed: 12/03/2022] Open
Abstract
Motor learning and compensatory movement are important aspects of prosthesis training yet relatively little quantitative evidence supports our current understanding of how motor control and compensation develop in the novel body-powered prosthesis user. The goal of this study is to assess these aspects of prosthesis training through functional, kinematic, and kinetic analyses using a within-subject paradigm compared across two training time points. The joints evaluated include the left and right shoulders, torso, and right elbow. Six abled-bodied subjects (age 27 ± 3) using a body-powered bypass prosthesis completed the Jebsen-Taylor Hand Function Test and the targeted Box and Blocks Test after five training sessions and again after ten sessions. Significant differences in movement parameters included reduced times to complete tasks, reduced normalized jerk for most joints and tasks, and more variable changes in efficiency and compensation parameters for individual tasks and joints measured as range of motion, maximum angle, and average moment. Normalized jerk, joint specific path length, range of motion, maximum angle, and average moment are presented for the first time in this unique training context and for this specific device type. These findings quantitatively describe numerous aspects of motor learning and control in able-bodied subjects that may be useful in guiding future rehabilitation and training of body-powered prosthesis users.
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Affiliation(s)
- Conor Bloomer
- Division of Biomedical Physics, Food and Drug Administration, Silver Spring, Maryland, United States of America
| | - Sophie Wang
- Division of Biomedical Physics, Food and Drug Administration, Silver Spring, Maryland, United States of America
- Department of Bioengineering, University of Maryland, College Park, Maryland, United States of America
| | - Kimberly Kontson
- Division of Biomedical Physics, Food and Drug Administration, Silver Spring, Maryland, United States of America
- * E-mail:
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Choukou MA, Best KL, Potvin-Gilbert M, Routhier F, Lettre J, Gamache S, Borisoff JF, Gagnon D. Scoping review of propelling aids for manual wheelchairs. Assist Technol 2019; 33:72-86. [DOI: 10.1080/10400435.2019.1595789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Mohamed-Amine Choukou
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Krista L. Best
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Maude Potvin-Gilbert
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - François Routhier
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Josiane Lettre
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Stéphanie Gamache
- Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Jaimie F. Borisoff
- Rehabilitation Engineering Design Laboratory, British Columbia Institute of Technology, Burnaby, BC, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
| | - Dany Gagnon
- School of Rehabilitation, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary Research of the Greater Montreal, Institut de réadaptation Gingras-Lindsay de Monntéral, Montréal, Canada
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Kloosterman MGM, Buurke JH, Schaake L, Van der Woude LHV, Rietman JS. Exploration of shoulder load during hand-rim wheelchair start-up with and without power-assisted propulsion in experienced wheelchair users. Clin Biomech (Bristol, Avon) 2016; 34:1-6. [PMID: 26999794 DOI: 10.1016/j.clinbiomech.2016.02.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 12/19/2015] [Accepted: 02/15/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Frequent start movements occurred during the day, yielding high upper-extremity stress. The high incidence and impact of shoulder injury on daily life wheelchair use made it clinically relevant to investigate whether power-assisted propulsion is beneficial during the start. METHODS Eleven hand-rim wheelchair users performed a start-movement in an instrumented wheelchair on a flat surface. Test order was randomly assigned to propulsion with and without power-assist. For each subject, parameters were averaged over 3 repeated starts. For statistical analysis Wilcoxon Signed Rank test was used. FINDINGS Intensity of mechanical shoulder loading decreased during power-assisted propulsion for anterior (147.0 (44.8) versus 121.9 (27.4) N; effect size (r)=-.75), posterior (4.8 (14.1) versus 2.7 (11.6) N; r=-.64) and inferior directed forces (82.6 (27.9) versus 68.9 (22.6) N; r=-.78) and abduction (20.2 (14.6) versus 12.9 (7.8) Nm; r=-.88) and extension moments (20.3 (10.7) versus 13.7 (9.1 Nm; r=-.88). Peak resultant force at the rim significantly decreased from 133.5 (38.4) N to 112.2 (25.4) N (r=-.64) and was accompanied by significant decreased shoulder abduction (35.3 (6.7) versus 33.3 (6.8); r=-.67) and significant increased shoulder extension (13.6 (16.3) versus 20.3 (19.1); r=-.78) during power-assisted start-up. INTERPRETATION Power-assist hand-rim wheelchairs are effective in reducing external shoulder load and partly effective in reducing force generation in extremes of shoulder motion during start-up. The use of power-assist wheels might reduce the risk of developing shoulder overuse injuries. CLINICAL TRIAL REGISTRATION NUMBER NTR2661.
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Affiliation(s)
- Marieke G M Kloosterman
- Roessingh Research and Development, Enschede, The Netherlands; Faculty of Engineering Technology, Laboratory of Biomechanical Engineering, University of Twente, Postbox 217, 7500 AE Enschede, The Netherlands.
| | - Jaap H Buurke
- Roessingh Research and Development, Enschede, The Netherlands; Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Biomedical Signals and Systems, University of Twente, Postbox 217, 7500 AE Enschede, The Netherlands.
| | | | - Lucas H V Van der Woude
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Postbox 30.001, 9700 RB Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Postbox 30.001, 9700 RB Groningen, The Netherlands.
| | - Johan S Rietman
- Roessingh Research and Development, Enschede, The Netherlands; Faculty of Engineering Technology, Laboratory of Biomechanical Engineering, University of Twente, Postbox 217, 7500 AE Enschede, The Netherlands.
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