Wheelchair propulsion biomechanics: implications for wheelchair sports

The role of power and kinetic asymmetry in differentiating elite vs. sub-elite wheelchair rugby sprint performance

Wheelchair sprint performance varies by sports classification. Yet, it is unclear how spatio-temporal, kinetic and kinetic asymmetries of wheelchair sprinting differ among wheelchair rugby players of different performance standard. The study purpose was to examine the associations between 30s sprint performances and spatio-temporal, kinetic and kinetic asymmetries on a dual-roller ergometer in elite and sub-elite wheelchair rugby players (n = 20). Kinetic differences between groups were investigated using statistical parametric mapping. Peak velocities were associated with the acceleration phase and higher peak power (r = 0.62, p = 0.003) and lower push times (r=-0.50, p = 0.020). Greater distance travelled during the acceleration phase were correlated with lower asymmetries in peak power (r=-0.58, p = 0.005). Overall, both peak velocity and total distance covered during the entire sprint was correlated with lower push times (r=-0.61, p = 0.003 and r=-0.62, p = 0.003) but greater peak power (r=-0.61, p = 0.003 and r=-0.62, p = 0.003). Elite players had lower power asymmetries between 1 to 15% and 95 to 100% of the push phase during the acceleration phase, accompanied by a lower initial contact asymmetry (p = 0.011). While power is an essential feature of sprinting, our findings show that how it is applied, in terms of asymmetry and coordination might differentiate the performance in wheelchair rugby.

Trying to use temporal and kinematic parameters for the classification in wheelchair badminton

INTRODUCTION

This study explores the potential for the temporal and kinematic datas link to propulsion technique and athlete performance collected here to contribute to evidence-based classification for wheelchair badminton athletes.

MATERIALS AND METHODS

Nineteen experienced wheelchair badminton players underwent propulsion tests with a badminton racket. Wheelchair were equipped with inertial measurement units. The first analysis conducted involved comparing the parameters between class WH1 and WH2. Subsequently, a hierarchical clustering analysis was performed on the parameters with significant differences.

RESULTS

Regarding propulsion technique parameters, WH1 athletes exhibit a longer braking phase compared to WH2 athletes. Generally, the performance of WH1 athletes is inferior to that of WH2 athletes. Concerning hierarchical clustering analysis, the results reveal the formation of three clusters based on principal components explaining 70% of the variation in the parameters considered in the analysis.

CONCLUSION

Thus, the results of this study indicate a longer braking time for WH1 athletes compared to WH2, along with lower overall performance. The clusters results could suggest a potential evolution of the current classification towards three distinct classes of wheelchair badminton players. However, these findings should be interpreted with caution, given that the included performance parameters can be influenced by numerous factors, potentially undermining the robustness of the clustering methodology employed. This study highlights the need to strengthen the current classification process in wheelchair badminton.

Objective Evaluation of Out-of-Competition Volume of Action in Wheelchair Basketball Classification

In wheelchair basketball, classes are based on competition observations. Since 2021, out-of-competition testing has been implemented; however, research remains limited. This study aimed to determine whether the quantified volume of action (VOA) can be an indicator for classification and examined the influence of a competitive wheelchair on VOA evaluation. This cross-sectional study included 47 wheelchair basketball players (21 able-bodied, 26 with physical impairments: class 1, n = 8; class 2, n = 5; class 3, n = 4; class 4, n = 9). Tests were performed in a wheelchair (wheelchair condition) and on a trainer bed (bed condition). Participants held a ball and rotated their trunks in various planes. Movements were recorded using four cameras, and position coordinates were extracted using the three-dimensional DLT method. Classes and sitting conditions were compared across five groups: classes 1, 2, 3, 4, and able-bodied. Comparisons between classes revealed significant differences in all planes, including wheelchair and bed conditions (p < 0.05). The VOA expanded in the wheelchair condition compared to the bed condition across multiple classes and planes (p < 0.05). Measuring the VOA outside the competition while sitting on a bed may effectively classify players by eliminating equipment influence.

Upper limb muscle strength and wheelchair-related abilities following an exoskeleton-assisted walking programme in individuals with chronic spinal cord injury: An exploratory study

OBJECTIVES

To measure the potential effects of an overground exoskeleton-assisted walking programme on upper limb strength and mass, as well as on wheelchair propulsion performances and abilities in individuals with chronic spinal cord injury.

DESIGN

Prospective, single-group, pre-post intervention study.

PARTICIPANTS

Ten individuals with chronic (≥ 18 months) spinal cord injury who use a wheelchair as their primary mode of locomotion and who had little-to-no motor function in the lower limbs.

METHODS

Individuals completed a progressive 16-week exoskeleton-assisted walking programme (34 × 1-h sessions, 1-3 sessions/week). Upper limb muscle strength was measured with dynamometers (isokinetic, Jamar). Upper limb lean mass (dual-energy X-ray absorptiometry) was used to calculate relative strength. Field tests (20-m wheelchair propulsion, and slalom test) and the Wheelchair Skills Test Questionnaire determined performances and abilities. Wilcoxon signed-rank tests were used with the following criteria: p < 0.1, effect size ≥ 0.5, and relative variation > 5%.

RESULTS

Only natural velocity during the 20-m wheelchair propulsion test (i.e., fundamental wheelchair ability) changed following the intervention (p = 0.01, effect size = 0.82, relative variation = +14.5%).

CONCLUSION

Overall, upper limb muscle function did not significantly and meaningfully change following the exoskeleton-assisted walking programme in this population. Additional research is needed to verify how changes in training volume would affect strength and advanced wheelchair-related abilities and performance, as well as the response in individuals who are deconditioned or novices to wheelchair use (e.g., subacute spinal cord injury).

The Effectiveness of Warm-Up Using an Assistive Device in Wheelchair Basketball: A Feasibility Study of Able-Bodied Participants

Introduction A warm-up is often performed to prevent injury and prepare for optimal performance. Nonetheless, research on its impact on performance, particularly in para-sports, remains limited. We hypothesized that the use of an assistive device during warm-up would enable wheelchair basketball players to perform full-body movements efficiently and effectively, contributing to enhanced wheelchair mobility. Therefore, this feasibility study aimed to assess the safety of warm-up exercise with an assistive device and the changes in wheelchair mobility performance before and after warm-up in able-bodied participants. Methods Thirteen able-bodied participants (nine males and four females; mean age: 34.3 ± 6.11 years) were analyzed. Warm-up consisted of a five-minute stand-up exercise using the lumbar-type Hybrid Assistive Limb®. Before and after warm-up, a 3-3-6 m sprint was performed as a wheelchair mobility performance test. The 3-3-6 m sprint is a test in which the athlete repeatedly accelerates, decelerates, and stops while driving at maximum effort for a total of 12 m (0-3 m, 3-6 m, and 6-12 m). The time required for the 3-3-6 m sprint and maximum instantaneous speed, acceleration time, deceleration time, hip joint angle, and average muscle activity of the lower limb and trunk muscles during the acceleration/deceleration phase of each section were compared before and after warm-up exercise. Results Warm-up with an assistive device was safe in healthy participants. The time required for the 3-3-6 m sprint was significantly reduced after the warm-up compared to that before the warm-up (p=0.005). Although not significant, there was a trend toward shorter deceleration times after the warm-up for participants herein. Conclusions In able-bodied participants, warm-up with an assistive device is safe; it may improve wheelchair mobility performance. Further research is required to determine its impact on para-athletes with disabilities.

Performance, asymmetry and biomechanical parameters in wheelchair rugby players

The practice of the wheelchair rugby is becoming more and more worldwide. However, few biomechanical studies have focused on this sport. The aim of this study was to compare kinematic parameters of wheelchair rugby players, classified as defensive players (LP-D) versus offensive players (HP-O). Twenty-nine wheelchair rugby players (17 LP-D and 12 HP-O) performed a 20-m sprint test. The peak velocities, temporal parameters (propulsion phase time, deceleration phase time, cycle time and cycle frequencies) and asymmetries (the difference in peak velocities between the right and the left wheels) were measured at the acceleration and constant peak velocity phases of the sprint by an inertial measurement unit which was placed on each rear wheel. At the acceleration and constant peak velocity phases, peak velocities and cycle frequencies were higher in HP-O players than LP-D players. The deceleration phase times and the cycle times were higher in LP-D players than HP-O players. However, no significant difference in asymmetry was found between LP-D players and HP-O players. The HP-O players showed superior performance than the LP-D players, but they could be more exposed at risk of injury at their upper limbs than LP-D players.

Neuromuscular Fatigue after Small-Sided Games in Wheelchair Basketball Players with and without Spinal Cord Injury

Purpose: The aim was to analyze the differences between wheelchair basketball players with Spinal Cord Injury (SCI) and without Spinal Cord injury (Non-SCI) in psycho-physiological response and neuromuscular fatigue in a series of small-sided games (SSG). Methods: Thirteen high-level wheelchair basketball male players (age 28.8 ± 9.2 years, body mass 75.9 ± 11.3 kg) participated in four versus four SSG once a week for five consecutive weeks. Absolute and relative heart rate (HR) during SSG and muscular and respiratory perceived exertion (RPEmus and RPEres), tympanic temperature, and acceleration capacity were recorded at the end of each SSG. Results: No significant differences were observed between SCI and non-SCI players in relative HR variables in SSG series. However, the SCI group had a lower absolute HR (mean HR and peak HR) (p < .05 or p < .01, ES = 0.73-1.39) and higher perceived muscular load (RPEmusTL) (p < .01, ES = 0.75-0.82) during SSG. Regarding the evolution of the physiological response, no differences were observed between the four bouts in the SCI group. However, the Non-SCI group showed an increase in the absolute and relative variables of HR and RPEres and RPEmus (p < .05 or p < .01, ES = 0.45-1.06). On the contrary, only the SCI group showed a loss of acceleration capacity between the four series (p < .05, ES = 0.28-0.35). Conclusion: The results of this study show that there are differences between SCI and non-SCI wheelchair basketball players in their physiological response and acceleration capacity during SSG tasks.

Electromyographic and kinematic parameters of the shoulder in wheelchair rugby players: case reports

Wheelchair rugby was created as part of the rehabilitation for patients with spinal cord injury. The biomechanical analysis of wheelchair propulsion (WP) in these athletes seems to be a key element to understand the reasons behind musculoskeletal injuries. This case reports study aimed to describe the electromyographic activity and kinematic parameters of the shoulder during the propulsion phases on the wheelchair in two Paralympic rugby players (A1 and A2) with spinal cord injury. Myoelectric activity (three portions of the deltoid, biceps and triceps brachii) and kinematics of the shoulder were assessed during the push (PP) and recovery (RP) phases. These variables were calculated considering ten propulsion cycles by each athlete. The results showed a different muscle activation between players, A1 described a high average amplitude of the anterior deltoid (PP = 58.44 ± 16.35%MVC; RP = 43.16 ± 13.48%MVC) in both propulsion phases, while A2 generated high average activity of triceps brachii (29.28 ± 10.63%MVC) and middle deltoid (46.53 ± 14.48%MVC), during PP and RP, respectively. At the same time, the player with a C7-T1 spinal cord injury (A2) showed a higher range of motion in the three plans, considering both propulsion phases.

The interaction between wheelchair configuration and wheeling performance in wheelchair tennis: a narrative review

The number of wheelchair tennis players is rising internationally, yet from a scientific perspective little is known about wheelchair tennis performance. Wheelchair tennis is more complex compared to other wheelchair court sports, due to the wheelchair/racket interaction. The purpose of this narrative review was to gain insight into the influence of wheelchair configuration, i.e., the individual set-up of a wheelchair, on wheelchair tennis performance, more specifically on wheelchair mobility performance and propulsion technique. Wheelchair propulsion while holding a racket has had little attention in both the wheelchair mobility performance and wheelchair propulsion technique area. It is shown that the propulsion technique and wheelchair mobility performance are negatively affected by the racket. Based on the current literature, the influence of wheelchair configuration on wheeling performance in wheelchair tennis can mainly be described from a broader wheelchair court sport perspective, due to the lack of specific publications about wheelchair tennis. In the future more research should be conducted on wheeling performance and wheelchair configuration in wheelchair tennis, to attain a more proper scientific foundation for optimising wheelchair tennis performance.

Impact of floor covering on wheelchair rugby players: analysis of rolling performance

Introduction

Despite the increased interest in indoor wheelchair sports in many countries, research on the effect of floor coverings on sports performance is limited. Currently, there are no specific guidelines for covering characteristics for wheelchair sports, whether for competitive or recreational purposes. This study aimed to determine the impact of floor coverings on the biomechanical parameters of manual wheelchair propulsion for wheelchair rugby practice.

Methods

Ten wheelchair rugby players performed 6 maximum-velocity sprints over 20 meters, with a 20-second recovery time between sprints, on 3 different coverings, using their personal sports wheelchairs. The coverings were: wood parquet, Gerflor TX System Endurance®, and a plastic synthetic covering (balatum). Performance and propulsion technique variables were collected using inertial measurement units (265 Hz, Kinvent, France). Additionally, rolling resistance quantification tests were conducted on each covering.

Results

Rolling resistance was lowest on the wood parquet, with an average value of 3.98 ± 0.97 N. Best sprint performance was achieved on the wood parquet. The fatigue index on the parquet was significantly lower than on the balatum (p < 0.05).

Discussion

Our results highlight that floor surface influences both performance and propulsion technique variables. Therefore, we recommend performing wheelchair rugby training on wood parquet to optimize performance. It is also important to consider the impact of different coverings on sprint performance when organizing player rotations to maintain a high level of competition during tournaments.

Women's wheelchair basketball lineup analysis at the Tokyo 2020 paralympic games: game related statistics explaining team sport performance

Introduction

Performance analysis through game-related statistics in wheelchair basketball (WB) has focused mainly on the study of the individual efficiency of players according to their functional classification. However, there is little evidence focusing on lineup performances (five players on court) and their composition. Thus, the objective of present study was to analyze the efficiency of the women's WB lineups used during the Tokyo 2020 Paralympic Games (PG) and to determine the variables that best discriminated the lineup performances according to the final point differential.

Methods

The sample comprised 507 lineups used in the 31 games by the 10 national teams during the competition. Fifty-one different lineup types (LTs) were categorized. A discriminant analysis was carried out to compare the lineups with a positive and negative point difference according to the game type (balanced and unbalanced games).

Results

It was found that LTs 16 (1-1.5-2.5-4-4.5), 47 (1-2-2.5-4-4.5) and 14 (1-1.5-2.5-4.5-4.5) had the best means of efficiency in field goals (LT 16 = 52%; LT 47 = 44% and LT = 40%), while LT 50 (1-2-3-4-4) obtained the highest mean difference in points (3.67 ± 10.67). The variables that best discriminated winner teams in balanced games were field goal efficiency (SC = 0.55), assists (SC = 0.50) and turnovers (SC = -0.41).

Discussion

Field goal efficiency, assists, turnovers and steals are the game-related statistics most associated with the success of a lineup used in balanced games in WB in PG competition; this could be taken into account by coaches when deciding how to compose a given lineup in a moment of the game, to adequately select players from different functional classifications for the final squad and to choose training content related to the indicated game-related statistics, as they explain success at this competition level.

Moving forward: A review of continuous kinetics and kinematics during handcycling propulsion

Wheelchair users (WCUs) face high rates of shoulder overuse injuries. As exercise is recommended to reduce cardiovascular disease prevalent among WCUs, it is becoming increasingly important to understand the mechanisms behind shoulder soft-tissue injury in WCUs. Understanding the kinetics and kinematics during upper-limb propulsion is the first step toward evaluating soft-tissue injury risk in WCUs. This paper examines continuous kinetic and kinematic data available in the literature. Attach-unit and recumbent handcycling are examined and compared. Athletic modes of propulsion such as recumbent handcycling are important considering the higher contact forces, speed, and power outputs experienced during these activities that could put users at increased risk of injury. Understanding the underlying kinetics and kinematics during various propulsion modes can lend insight into shoulder loading, and therefore injury risk, during these activities and inform future exercise guidelines for WCUs.

Shoulder pain in wheelchair basketball athletes: A scoping review

CONTEXT

Wheelchair basketball athletes have increased upper limb stress, which frequently leads to shoulder pain.

OBJECTIVE

The purpose of this scoping review was to summarize the existing literature on shoulder pain in wheelchair basketball athletes.

METHODS

We searched PubMed, Cochrane Library, Scopus, and PEDro databases for studies performed between January 1990 and February 2021. Two independent reviewers screened the studies according to the inclusion and exclusion criteria. Participants' characteristics and results were extracted from the study.

RESULTS

The initial database search yielded 2455 articles, 11 of which met the inclusion criteria. This review included seven studies in its final analysis; among them, seven determined the prevalence and incidence of shoulder pain, five investigated the factors and mechanisms contributing to shoulder pain, and two reported the treatment and preventive measures. The prevalence of shoulder pain in wheelchair basketball players ranged from 38%-75%, and the incidence of shoulder pain was 14%. Factors/mechanisms included overuse, decreased trunk control, and driving posture. Treatment/preventive measures consisted of shoulder and scapular muscle strengthening and stretching exercises. However, the literature on treatment/prevention was scarce, and its effectiveness was unclear.

CONCLUSION

This scoping review confirmed the high prevalence of shoulder pain in wheelchair basketball players; despite this, studies regarding treatment or preventive measures remain lacking. Further studies investigating the mechanism of onset of shoulder pain and the effectiveness of therapeutic and preventive measures are needed in the future.

The effects of trunk kinematics and EMG activity of wheelchair racing T54 athletes on wheelchair propulsion speeds

Background

The purpose of this study is to examine the impact of trunk kinematic characteristics and trunk muscle electromyography (EMG) activity on propulsion speeds in wheelchair racing T54 athletes.

Method

The Vicon infrared high-speed 3D motion capture system was utilized to acquire kinematic data of the shoulders, elbows, wrists, and trunk from twelve T54 athletes at four different speeds (5.55 m/s, 6.94 m/s, 8.33 m/s, and personal maximum speed). Additionally, the Trigno Wireless EMG system was employed to collect synchronous surface electromyography (EMG) data from the rectus abdominis and erector spinae muscles. The kinematics and EMG data of the trunk were compared across various wheelchair propulsion speeds while also examining the correlation coefficient between wheelchair propulsion speeds and: (1) the range of motion of upper limb joints as well as the trunk; (2) the maximum angular velocities of the upper limbs joints as well as the trunk; and (3) rectus abdominis and erector spinae EMG activity. Two multiple linear stepwise regression models were utilized to examine the impact of variables that had been identified as significant through correlation coefficient tests (1) and (2) on propulsion speed, respectively.

Results

There were significant differences in the range of motion (p<0.01) and angular velocity (p<0.01) of the athlete's trunk between different propulsion speeds. The range of motion (p<0.01, r = 0.725) and angular speed (p<0.01, r = 0.882) of the trunk showed a stronger correlation with propulsion speed than did upper limb joint movements. The multiple linear stepwise regression model revealed that the standardized β values of trunk motion range and angular velocity in athletes were greater than those of other independent variables in both models. In terms of the EMG variables, four of six variables from the rectus abdominis showed differences at different speeds (p<0.01), one of six variables from the erector spinae showed differences at different speeds (p<0.01). All six variables derived from the rectus abdominis exhibited a significant correlation with propulsion speed (p<0.05, r>0.3), while one variable derived from the erector spinae was found to be significantly correlated with propulsion speed (p<0.01, r = 0.551).

Conclusion

The movement of the trunk plays a pivotal role in determining the propulsion speed of wheelchair racing T54 athletes. Athletes are advised to utilize trunk movements to enhance their wheelchair's propulsion speed while also being mindful of the potential negative impact on sports performance resulting from excessive trunk elevation. The findings of this study indicate that it would be beneficial for wheelchair racing T54 athletes to incorporate trunk strength training into their overall strength training regimen, with a specific emphasis on enhancing the flexion and extension muscles of the trunk.

A novel method for estimating sternoclavicular posterior rotation with promising accuracy: A validity comparison with minimizing acromioclavicular rotation approach

The human shoulder complex's motion is modeled by nine rotational degrees of freedom (DoF) at the sternoclavicular (SC), acromioclavicular (AC), and glenohumeral joints. Non-invasive measurement of these rotations is desirable for shoulder kinematic assessment or musculoskeletal modeling. Accuracy of the conventional method for estimating SC posterior rotation is unclear and might be overestimated because it assumes no rotation in the AC joint. We aimed to explore whether our new method, allowing AC rotation, provides a more accurate estimation of SC posterior rotation than the conventional method. We compared estimates by both methods, in 18 postures among 8 healthy men, with those measured by the registration method from magnetic resonance images. Posthoc analyses showed significant differences between the registration and conventional methods in all 18 postures and in only one posture when compared to our method. While the conventional method tended toward overestimation and showed a 22.7° root-mean-square error for all postures, the new method had greater accuracy (6.8° root-mean-square error). By combining this method with the scapulothoracic rotation measurement method and other traditional methods, it should be possible to indirectly measure 3-DoF AC rotation, implying that non-invasive measurement of all 9-DoF rotations of the shoulder complex would now be possible.

Ten steps to becoming a musculoskeletal simulation expert: A half-century of progress and outlook for the future

Over the past half-century, musculoskeletal simulations have deepened our knowledge of human and animal movement. This article outlines ten steps to becoming a musculoskeletal simulation expert so you can contribute to the next half-century of technical innovation and scientific discovery. We advocate looking to the past, present, and future to harness the power of simulations that seek to understand and improve mobility. Instead of presenting a comprehensive literature review, we articulate a set of ideas intended to help researchers use simulations effectively and responsibly by understanding the work on which today's musculoskeletal simulations are built, following established modeling and simulation principles, and branching out in new directions.

Characteristics of Falls Among Men’s Wheelchair Rugby Players in the Rio 2016 and Tokyo 2020 Summer Paralympic Games: A Video Analysis

Wheelchair rugby is a contact sport in which falls are common and injury rates are high, yet the characteristics of the falls are still under-reported. We investigated the fall characteristics of men’s wheelchair rugby players by functional classification, using all 36 official match videos from the Rio 2016 and Tokyo 2020 summer Paralympic Games. The videos were analyzed to evaluate the number of falls, playing time when the fall occurred, playing phase (offense or defense), contact with other players, foul judgement, direction of the fall, and the body part first in contact with the floor. All 182 men’s wheelchair rugby players (Rio 2016, 94; Tokyo 2020, 88) were classified as low-point players or high-point players depending on their functional classification. A total of 200 falls were detected, 27 (13.5%) for low-point players and 173 (86.5%) for high-point players. Significant differences were noted between low-point players and high-point players in the direction of the fall and body part first in contact with the floor. High-point players had more falls in the forward and left-right directions, whereas low-point players were characterized by a higher percentage of falls in the left-right and backward directions. Additionally, high-point players landed on the floor with their hands with high frequency, whereas low-point players landed with their elbows and shoulders more often. Our findings suggest the significance of devising measures to prevent falls during men’s wheelchair rugby games according to their functional classification.

A newly developed hand rim for wheelchair tennis improves propulsion technique and efficiency in able-bodied novices

A new wheelchair tennis hand rim was developed, having a larger contact area and higher friction. How does this new hand rim compare to a regular hand rim regarding submaximal propulsion with a tennis racket during practice in novices? Twenty-four able-bodied novices (12 Regular Rim, 12 New Rim) completed a one-day experiment: pre-test, three practice-sessions and a post-test of 3 × 4 min each on a wheelchair ergometer (1.11 m/s, 7W). The New Rim group compared to the Regular Rim group, had a lower negative work per cycle (-0.83J vs. -2.06J, p = 0.01) at the post-test. There was a significantly larger increase in mechanical efficiency between the pre- and post-test in the New Rim group (2.3-3.4% vs. 2.1-2.5%, p = 0.02) compared to the Regular Rim group. The new rim led to a more ergonomic propulsion technique, with a reduction in negative power and higher mechanical efficiency between the pre- and post-test at submaximal propulsion.

¿CÓMO PREVENIR EL DOLOR DE HOMBRO EN BALONCESTO EN SILLA DE RUEDAS?

Las lesiones del hombro suponen un problema en el baloncesto en silla de ruedas (BSR). El objetivo de este estudio fue determinar la eficacia de un programa de ejercicio para el dolor del hombro en jugadoras de máximo nivel de BSR para tras 12 semanas de intervención a lo largo del proceso preparatorio de una competición internacional. Participaron 13 jugadoras de BSR de la Pre-Selección Española Femenina (edad 26.6 ±6.1 años), respondiendo a un cuestionario de DH antes y después del programa de ejercicio, evaluando también el rango de movimiento (RM) y aplicando pruebas funcionales. El DH se redujo significativamente después de la intervención (Z=-2.93, p?0.05, d=0.67), pero sin cambios significativos ni en las pruebas funcionales (p?0.05) ni en el RM (p?0.05). El programa de ejercicio resultó efectivo para la reducción del DH durante el proceso de preparación, lo que influyó de manera positiva en rendimiento deportivo de las jugadoras.

Prediction of Propulsion Kinematics and Performance in Wheelchair Rugby

Prediction of propulsion kinematics and performance in wheelchair sports has the potential to improve capabilities of individual wheelchair prescription while minimizing testing requirements. While propulsion predictions have been developed for daily propulsion, these have not been extended for maximal effort in wheelchair sports. A two step-approach to predicting the effects of changing set-up in wheelchair rugby was developed, consisting of: (One) predicting propulsion kinematics during a 5 m sprint by adapting an existing linkage model; and (Two) applying partial least-squares regression to wheelchair set-up, propulsion kinematics, and performance. Eight elite wheelchair rugby players completed 5 m sprints in nine wheelchair set-ups while varying seat height, seat depth, seat angle, and tire pressure. Propulsion kinematics (contact and release angles) and performance (sprint time) were measured during each sprint and used for training and assessment for both models. Results were assessed through comparison of predicted and experimental propulsion kinematics (degree differences) for Step One and performance times (seconds differences) for Step Two. Kinematic measures, in particular contact angles, were identified with mean prediction errors less than 5 degrees for 43 of 48 predictions. Performance predictions were found to reflect on-court trends for some players, while others showed weaker prediction accuracy. More detailed modeling approaches that can account for individual athlete activity limitations would likely result in improved accuracy in propulsion and performance predictions across a range of wheelchair sports. Although this would come at an increased cost, developments would provide opportunities for more suitable set-ups earlier in an athlete's career, increasing performance and reducing injury risk.

Effects of trunk muscle activation on trunk stability, arm power, blood pressure and performance in wheelchair rugby players with a spinal cord injury

Objective: In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.Design: Cross-sectional study.Setting: Rehabilitation research laboratory and WR court.Participants: Eleven WR athletes with tetraplegia.Interventions: ES was applied to the rectus abdominis, obliquus externus abdominis and erector spinae muscles. For every test, the ES condition was compared to the non-ES condition.Outcome measures: Stability was assessed with reaching tasks, arm force/power with an isokinetic test on a dynamometer, BP during an ES protocol and WR skill performance with the USA Wheelchair Rugby Skill Assessment.Results: Overall reaching distance (ES 14.6 ± 7.5 cm, non-ES 13.4 ± 8.2 cm), and BP showed a significant increase with ES. Arm force (ES 154 ± 106 N, non-ES 148 ± 102 N) and power (ES 37 ± 26 W, non-ES 36 ± 25 W), and WR skills were not significantly improved.Conclusion: ES-induced trunk muscle activation positively affects trunk stability and BP, but not arm force/power. No effects were found in WR skill performance, probably due to abdominal strapping. More research is needed to assess different ES (training) protocols and longitudinal effects.

WISP, Wearable Inertial Sensor for Online Wheelchair Propulsion Detection

Manual wheelchair dance is an artistic recreational and sport activity for people with disabilities that is becoming more and more popular. It has been reported that a significant part of the dance is dedicated to propulsion. Furthermore, wheelchair dance professionals such as Gladys Foggea highlight the need for monitoring the quantity and timing of propulsions for assessment and learning. This study addresses these needs by proposing a wearable system based on inertial sensors capable of detecting and characterizing propulsion gestures. We called the system WISP. Within our initial configuration, three inertial sensors were placed on the hands and the back. Two machine learning classifiers were used for online bilateral recognition of basic propulsion gestures (forward, backward, and dance). Then, a conditional block was implemented to rebuild eight specific propulsion gestures. Online paradigm is intended for real-time assessment applications using sliding window method. Thus, we evaluate the accuracy of the classifiers in two configurations: “three-sensor” and “two-sensor”. Results showed that when using “two-sensor” configuration, it was possible to recognize the propulsion gestures with an accuracy of 90.28%. Finally, the system allows to quantify the propulsions and measure their timing in a manual wheelchair dance choreography, showing its possible applications in the teaching of dance.

Injuries in Wheelchair Basketball Players: A Systematic Review

BACKGROUND

Sports injuries have physical and psychological effects that negatively affect sports performance. Although there are data available on sports injuries in wheelchair basketball, some aspects need to be clarified, such as the location, mechanisms and risk factors for injury, which are not well described due to variations and/or a lack of definition of injury. The aim of this study was to determine epidemiological information, primary injury characteristics and affected body regions in wheelchair basketball players; Methods: The PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases were used; Results: eight articles were included in this review. The shoulder was the body region most affected (N = 60; 22.1%). When divided by body segments, the upper limbs were the most affected (N = 128; 47.2%), followed by the head and/or face (N = 53; 19.5%), trunk (included spine and ribs) (N = 48; 17.8%) and lower limbs (N = 42; 15.5%); Conclusions: wheelchair basketball players suffer a large number of injuries with different characteristics that are mainly linked to biomechanics and sport. These results can be used to guide coaches in structuring training to minimize recurring injuries, in addition to assisting in the organization of medical teams in competitions.

Evidence-Based Classification in Powerchair Football: Determining the Determinants

The purpose of this study was to initiate the development of an evidence-based sport classification system for powerchair football, a sport that serves athletes with physical impairments. Sport classification is designed to increase participation by minimizing the impact of impairment on competition outcome, and powerchair football lacks an evidence-based system of classification which is required of Paralympic sports. A number of approaches were used to build the theoretical model of sport performance (Step 2 of the International Paralympic Committee model). Key sport activities were identified through surveys of stakeholders and underlying determinants of those key activities were identified through game and database analyses. Current findings support drive control, ball control, communication, and adjustment to the ball as key activities in powerchair football with joint-specific strength and range of motion, sensory, and neurological variables identified as underlying determinants.

Learning of Wheelchair Racing Propulsion Skills Over Three Weeks of Wheeling Practice on an Instrumented Ergometer in Able-Bodied Novices

The acquisition of daily handrim wheelchair propulsion skill as a multi-layered phenomenon has been studied in the past. Wheelchair racing, however, is considerably different from daily handrim wheelchair propulsion in terms of propulsion technique, as well as the underlying equipment and interface. Understanding wheelchair racing skill acquisition is important from a general motor learning and skill acquisition perspective, but also from a performance and injury prevention perspective. The aim of the current lab-based study was 2-fold: to investigate the evolution of racing wheelchair propulsion skill among a sample of novices and to compare them with an experienced wheelchair racer under similar conditions. A convenience sample of 15 able-bodied novices (8 male, 7 female) completed a standardized three-week submaximal uninstructed practice protocol (3 weeks, 3 sessions per week, 3x4 min per session) in a racing wheelchair on an ergometer. Required wheeling velocity was set at 2.78 m/s (10 km/h) and a rolling friction coefficient of 0.011 (resulting in a mean target load of 21W) was used. For comparison, an experienced T54 Paralympic athlete completed one block of the same protocol. Kinetics, kinematics, and physiological data were captured. A mixed effects regression analysis was used to examine the effect of practice for the novices, while controlling for speed. All participants finished the protocol successfully. However, not all participants were able to achieve the target speed during the first few sessions. Statistically significant improvements over time were found for all outcome measures (i.e., lower metabolic strain, longer push and cycle times) with the exception of mean power and torque per push. The athlete used a significantly greater contact angle and showed “better” outcomes on most metabolic and kinetic variables. While the athlete used a semi-circular propulsion technique, most participants used a double looping over technique. Three weeks of uninstructed wheelchair racing practice significantly improved efficiency and skill among a group of novices, in line with previous studies on daily handrim wheelchair propulsion. The comparison with an experienced athlete expectedly showed that there is still a large performance (and knowledge) gap to be conquered.

Osteoid Osteoma in an Adult Wheelchair Basketball Player Mimicking Musculoskeletal Shoulder Pain: Red Flag or a Red Herring?

Osteoid osteoma (OO) is a relatively common, benign bone-forming tumour, which mainly occurs on the long tubular bones of the limbs in adolescents. Usually, the OO is classified based on its localisation. Night-time pain is the major symptom of OO, which is commonly relieved using non-steroidal anti-inflammatory drugs, while surgery is required only for those patients with severe pain or in case of failure of previous conservative treatments. Our case report describes a 56-year-old male basketball player who self-referred to our outpatient physical therapy with a shoulder pain complaint. Considering the anamnesis and the physical examination, the physical therapist referred the patient to an orthopaedic surgeon, who suggested a detailed imaging investigation. The peculiarity of this clinical case is the overlapping of two clinical presentations: the symptomatology of the OO and the concurrent mechanical disorder due to a rotator cuff tendinopathy.

Sprint performance and force application of tennis players during manual wheelchair propulsion with and without holding a tennis racket

The objective of this exploratory research is to study the impact of holding a tennis racket while propelling a wheelchair on kinetic and temporal parameters in a field-based environment. 13 experienced wheelchair tennis players with disabilities (36.1 ± 8.2 years, 76.8 ± 15.3 kg, 174.8 ± 17.1 cm) classified between 30/8 and first series performed two 20 m sprints in a straight line, on a tennis court: one while holding a tennis racket and the second without a tennis racket. They used their own sports wheelchair. Potential participants were excluded if they had injuries or pain that impaired propulsion. Maximal total force, maximal propulsive moment, rate of rise, maximal power output, push and cycle times and maximal velocity were measured. Sprinting while holding a tennis racket increased the cycle time by 0,051 s and push time by 0,011s. Sprinting while holding a tennis racket decreased the maximal propulsive moment, maximal power output, rate of rise and maximal velocity during propulsion by 6.713 N/m, 151.108 W, 672.500 N/s and 0.429 m/s, respectively. Our results suggest that the biomechanical changes observed associated with racket propulsion are generally in a direction that would be beneficial for the risk of injury. But sprinting holding a racket seems to decrease players propulsion performance. Working on forward accelerations with a tennis racket would be a line of work for coaches.

Describing a Set of Points with Elliptical Areas: Mathematical Description and Verification on Operational Tests of Technical Devices

The purpose of this article was to present an algorithm for creating an ellipse for any data set represented on a two-dimensional reference frame. The study objective was to verify the developed method on real results of experimental tests with different subject matter. This article contains a mathematical algorithm to describe a set of points with elliptical areas. In addition, four results of tests with different subject matter are cited, based on which the developed method was verified. The verification of the method included checking the deviation of the geometric dimensions of the ellipse, the number of points contained within the ellipse, and the area of the ellipse. The implemented research methodology allowed to demonstrate the possibility of using the method of describing a set of points with elliptical areas, in order to determine quantitative parameters evaluating the results of the test. The presented results show the method’s applicability for the results obtained in four different operational tests: measurement of the human body’s gravity center position for a person propelling a wheelchair, measurement of marker position using motion capture methods, measurement of particulate emissions when using equipment powered by an internal combustion engine, and measurement of the muscle activity of the upper limb when propelling a hybrid manual-electric wheelchair. The performed experiments demonstrated that the method allows to describe about 85% of all measurement points with an ellipse.

Relationship between Sprint Capacity and Acceleration of Wrists in Wheelchair Basketball Players: Design and Reliability of a New Protocol

The application of new technologies in wheelchair basketball (WB) is important for the advancement and improvement of athletic performance. The purposes of this study are twofold: (a) to develop a methodological design in order to assess WB players’ performance, using wireless inertial measurement units (WIMU^®) and a laser system (BioLaserSport^® with computer vision), in a 20 m sprint test on court and (b) to assess bilateral symmetry as a performance indicator and for injury prevention purposes, the study of which in previous research is unknown. For both aims, the relation of the acceleration of the players’ wrists to the speed achieved by the player in the wheelchair was explored. Ten elite WB players participated in an on-court 20 m sprint test during real training. BioLaserSport^® with computer vision was used to assess the average velocity (Va) and maximum velocity (Vmax) of the WB players, and two WIMU^® were used for the total acceleration (AcelT) of the players’ wrists. A very high correlation was obtained in the assessment of the Va (0.97) and AcelT of both wrists (0.90 and 0.85). There was a significant relationship between the average AcelT of the dominant wrist and the Va on-court sprint velocity (p < 0.05). Two players did not show good wrist symmetry. In conclusion, a new methodological protocol was developed, making it possible to assess the bilateral symmetries in elite WB players in on-court real training and the relation between the acceleration of players’ wrists and players’ wheelchair speed. Coaches can use this protocol to assess performance or for injury prevention, as it shows very good reliability, with high ICC values.

The Impact of the Human Body Position Changes During Wheelchair Propelling on Motion Resistance Force: A Preliminary Study

The aim of this research was to analyze the impact of the human body position changes caused by propelling a wheelchair with the pushrim propulsion on the value of motion resistance force. The discussed research works are in progress; therefore, the presented results should be treated as preliminary. The research was carried out in the group of six volunteers propelling a wheelchair of which frame was inclined, in respect to the horizontal plane, under the angle of 0 deg, 7 deg, and 14 deg. The area of the position variability of the human body center of gravity (COG) and the coefficients of wheelchair rolling resistance have been determined. Based on the measurements conducted, rolling resistance force FT and motion resistance force FR have been defined for three values of frame inclination angle. The determined force of rolling resistance Ft depended on the location of the COG of the human body and the value of the coefficients of rolling resistance of the front and rear wheels of a wheelchair. This force was a component of the resistance to motion FR, which also took into account the influence of gravity resulting from the inclination of the wheelchair on an inclined plane. For the tested inclination angles relative to the horizontal plane, the rolling resistance force ranged from 9.82 N to 22.81 N. Analyzing the variability of the rolling resistance force FT, it was found that for the final phase of the driving motion, it increased by 36% for the inclination angle of 0 deg and 43% for the inclination angle of 7 deg. Its increase was 48% for the inclination angle of 14 deg in relation to the human body position for the beginning of the driving motion. In the case of measuring the value of the resistance to motion FR, it was observed that, depending on the angle of the incline of the wheelchair, it ranged from 14.69 N to 256.33 N. The measurements conducted enabled the derivation of an analytical model for determining rolling resistance force depending on the position of the human body COG and the wheelchair inclination angle. The conducted research demonstrated the impact of the COG position on the changes of motion resistance force, thus expanding the state of knowledge, introducing a new parameter which, like a surface type and wheel type, affects motion resistances.

Assessment of Wheelchair Propulsion Performance in an Immersive Virtual Reality Simulator

Maneuvering a wheelchair is an important necessity for the everyday life and social activities of people with a range of physical disabilities. However, in real life, wheelchair users face several common challenges: articulate steering, spatial relationships, and negotiating obstacles. Therefore, our research group has developed a head-mounted display (HMD)-based intuitive virtual reality (VR) stimulator for wheelchair propulsion. The aim of this study was to investigate the feasibility and efficacy of this VR stimulator for wheelchair propulsion performance. Twenty manual wheelchair users (16 men and 4 women) with spinal cord injuries ranging from T8 to L2 participated in this study. The differences in wheelchair propulsion kinematics between immersive and non-immersive VR environments were assessed using a 3D motion analysis system. Subjective data of the HMD-based intuitive VR stimulator were collected with a Presence Questionnaire and individual semi-structured interview at the end of the trial. Results indicated that propulsion performance was very similar in terms of start angle (p = 0.34), end angle (p = 0.46), stroke angle (p = 0.76), and shoulder movement (p = 0.66) between immersive and non-immersive VR environments. In the VR episode featuring an uphill journey, an increase in propulsion speed (p < 0.01) and cadence (p < 0.01) were found, as well as a greater trunk forward inclination (p = 0.01). Qualitative interviews showed that this VR simulator made an attractive, novel impression and therefore demonstrated the potential as a tool for stimulating training motivation. This HMD-based intuitive VR stimulator can be an effective resource to enhance wheelchair maneuverability experiences.

Investigating environmental factors and paralympic sports: an analytical study

PURPOSE

Few studies have reported the influence of environmental factors that may act as barriers or facilitators to participation in parasports. The aim of this study was to describe and analyse the relationship between environmental factors present in parasports (attitudes, support, services, assistive technology and policies). In addition, we present the concurrent validation of the Assistive Technology Device Predisposition Assessment (ATD PA-Br).

MATERIALS AND METHODS

Sixty-three adult Paralympic athletes with physical and/or visual impairment who practiced goalball, wheelchair tennis, table tennis, sitting volleyball, rugby, swimming, equestrianism, weightlifting, track and field, archery, bocce ball and parabadminton were analysed. Sociodemographic questionnaires, ATDPA-Br and QUEST B were used for data collection and analysed by 5% significance level (p < 0.05).

RESULTS

The findings showed a predominance of athletes with spinal cord injury playing rugby (11) and parabadminton (9), 25.4% exhibited low sociodemographic levels, 36.5% required a wheelchair and 9.6% used prostheses. Although 90.5% of participants reported that assistive technology helped them in their sport, they also expressed dissatisfaction with the services provided. There was a significant correlation between satisfaction with the device in the QUEST instrument and the positive psychosocial factors of the ATDPA-Br, meaning the larger the number of positive factors, the greater the satisfaction with the device.

CONCLUSION

This study showed the predominance of low-income parathletes and that environmental factor as access to the benefits of public policies, it may be a barrier to participation in parasports. Also, the technology and the services provided should act as facilitators to parasport performance.Implications for rehabilitationUnderstand the objectives of assistive technology in paralympic sports.Identify the environmental factors present in parasports (attitudes, support, services, assistive technology, and policies).Analyze the relationship between environmental factors present in parasports (attitudes, support, services, assistive technology, and policies).Have access to the concurrent validation of the Assistive Technology Device Predisposition Assessment (ATD PA-Br).

A high sample rate, wireless instrumented wheel for measuring 3D pushrim kinetics of a racing wheelchair

In wheelchair racing, measuring pushrim kinetics such as propulsion forces and moments is paramount for improving performance and preventing injuries. However, there is currently no instrumented racing wheel that records 3D pushrim kinetics wirelessly and at a high sample rate, which is necessary for accurately analysing wheelchair racing biomechanics. In this work, we present an instrumented wheel that measures 3D kinetics at 2500 Hz. Bidirectional wireless communication is used to interface the wheel through a smart phone. The wheel was tested with a world-class racing athlete who propelled at maximal acceleration and maximal speed on a training roller. During acceleration, the peak total force increased continuously from 186 N to 484 N while the peak tangential force was constant at 171 N ± 15 N. At higher speeds, a counterproductive tangential force was measured during the first 15% and the last 25% of the push phase, peaking at -78 N. This wheel may be of great value for both coaches and athletes to help with planning and validating training programs and adaptations to the wheelchair such as positioning. This wheel also has very high potential for further research on wheelchair racing biomechanics and on preventing shoulder pathologies associated with this sport.

The Symmetric Nature of the Position Distribution of the Human Body Center of Gravity during Propelling Manual Wheelchairs with Innovative Propulsion Systems

Objective: The main objective of the tests conducted was to analyze the position variability of the human body’s center of gravity during propelling the wheelchair, and to demonstrate the properties enabling the description of this variability by means of plane figures with a symmetry axis. A secondary objective was to show the impact of the used manual propulsion type and the wheelchair inclination angle in relation to the plane on the dimensions of the position variability areas of the center of gravity. Method and materials: Three patients participated in the research representing 50 centiles of anthropometric dimensions. Each patient carried out fifteen measurement tests on three wheelchairs for three inclination angles of the wheelchair frame in relation to the level. Each measurement test consisted of five propulsion cycles for which the positions of the center of gravity were determined with the sampling frequency of 100 Hz. The measured positions of the center of gravity were approximated with ellipses containing 95.4% of the measurements conducted, assuming their dimension scaling basis in the form of the double value of standard deviation defined based on the registered results. Results: Based on the measurements conducted, the average values of five ellipses parameters were determined for nine cases in which a variable was the type of wheelchair propulsion and its inclination angle in relation to the level. The area of the highest variability of the position of the center of gravity was measured for the wheelchair with a multispeed transmission. The average dimensions of the ellipse semi-axis amounted to 108.53 mm for the semi-axis a and 29.75 for the semi-axis b, the average position of the ellipse center amounted to x = 114.51 mm and y = −10.53 mm, and the average inclination angle of the ellipse α amounted to −6.92°. The area of the lowest variability of the position of the center of gravity was measured for the wheelchair with a hybrid transmission. In this case, the average dimensions of the ellipse semi-axis amounted to 64.07 mm for the semi-axis a and 33.85 for the semi-axis b; whereas, the average position of the ellipse center amounted to x = 245.13 mm and y = −28.24 mm, and the average inclination angle of the ellipse α amounted to −0.56°.

Relationship Between Power Output and Speed-Related Performance in Brazilian Wheelchair Basketball Players

This study aimed to investigate the association between the optimum power load in the bench press (BP), shoulder press (SP), and prone bench pull (PBP) exercises and acceleration (ACC) and speed performances in 11 National Team wheelchair basketball (WB) players with similar levels of disability. All athletes were previously familiarized with the testing procedures that were performed on the same day during the competitive period of the season. First, athletes performed a wheelchair 20-m sprint assessment and, subsequently, a maximum power load test to determine the mean propulsive power (MPP) in the BP, SP, and PBP. A Pearson product-moment correlation was used to examine the relationships between sprint velocity (VEL), ACC, and the MPP in the three exercises. The significance level was set as p < .05. Large to very large significant associations were observed between VEL and ACC and the MPP in the BP, SP, and PBP exercises (r varying from .60 to .77; p < .05). The results reveal that WB players who produce more power in these three exercises are also able to accelerate faster and achieve higher speeds over short distances. Given the key importance of high and successive ACCs during wheelchair game-related maneuvers, it is recommended that coaches frequently assess the optimum power load in BP, SP, and PBP in WB players, even during their regular training sessions.

Relationship between Sprint Velocity and Peak Moment at Shoulder and Elbow in Elite Wheelchair Basketball Players

Specific wheelchair basketball (WB) skills on the court have been poorly analyzed in relation to improving players’ performance according to their functional class. The purpose of this study was to evaluate the associations between maximum velocity (Vmax) and peak moment (PM) in the shoulder and elbow joints in specific WB skills and to compare performance between the main two groups by functional class. Twelve male WB players, divided in categories A (functional classes 1.0–2.5) and B (class 3.0–4.5), performed a sprint test battery composed by four tests (with and without ball) and isokinetic tests. A significant relationship between PM of the internal and external shoulder rotation and the flexion and extension elbow with Vmax (p < 0.05) was found. During a 5 m backward sprint test, category B was faster in the last three meters than category A (p < 0.05) and also for the rest of the test but p = NS. Category B showed higher PM than category A for internal shoulder rotation (ISR) at 60 °/s and at 180 °/s on the dominant side (DS) (p < 0.05). In conclusion, ISR on the DS was found different for both groups and showed significant relationship with Vmax in all of the tests performed. Moreover, at higher speeds the elbow flexion and extension in DS were correlated with Vmax in all the actions with ball (passing, bouncing, and braking) reflected the importance of these joints movements in acquiring speed when performing sport specific WB skills.

Understanding the task demands for powered wheelchair driving: a think-aloud task analysis

BACKGROUND

Powered wheelchair use promotes participation in individuals with limited mobility, however training is required for safe and effective use. There is limited evidence on the task demands of powered wheelchair use to inform an evidence-based skills training programme.

OBJECTIVE

To conduct a systematic exploration of the task demands of indoor powered wheelchair use to identify frequently used skills, abilities, and knowledge.

METHODS

We used a two-phased think aloud process to conduct a task analysis of powered wheelchair use with experienced powered wheelchair users (n = 5) and expert clinicians (n = 5). Participants completed seven indoor driving tasks while speaking aloud (concurrent think aloud) and subsequently engaged in a structured qualitative interview to discuss skills, abilities, and knowledge used across each of the seven tasks (retrospective think aloud). We used directed content analysis to map the skills and abilities to the ICF framework and conventional content analysis to develop thematic areas of knowledge used while operating a powered wheelchair.

RESULTS

One-hundred and ten (110) distinct skills and abilities were identified and mapped to the ICF; 80 in the Body Structures and Functions domain, and 30 in the Activities and Participation domain. Approximately 50% of skills and abilities were mental functions. Four thematic knowledge domains were identified: knowledge of self, environment, wheelchair, and task.

CONCLUSION

Powered wheelchair use is complex and requires a variety of skills and abilities from all areas of human functioning, in addition to a wide range of knowledge. Training programmes should address a range of areas of skill development.IMPLICATIONS FOR REHABILITATIONPowered wheelchair use is a complex skill; training should develop skills from all.Domains of the ICF, including mental and physical functions.A range of knowledge is used while operating a powered wheelchair; training programs.Should include the development and application of necessary knowledge.Clinicians may consider a range of factors when assessing suitability for powered.Wheelchair user, however should acknowledge that while the range of skills idenotified.May be useful, they may not be critical for success in powered wheelchair use.

Predictive Forward Dynamic Simulation of Manual Wheelchair Propulsion on a Rolling Dynamometer

Research studies to understand the biomechanics of manual wheelchair propulsion often incorporate experimental data and mathematical models. This project aimed to advance this field of study by developing a two-dimensional (2D) model to generate first of its kind forward dynamic fully predictive computer simulations of a wheelchair basketball athlete on a stationary ergometer. Subject-specific parameters and torque generator functions were implemented in the model from dual X-ray absorptiometry and human dynamometer measurements. A direct collocation optimization method was used in a wheelchair propulsion model for the first time to replicate the human muscle recruitment strategy. Simulations were generated for varying time constraints and seat positions. Similar magnitudes of kinematic and kinetic data were observed between simulation and experimental data of a first push. Furthermore, seat heights inferior to the neutral position were found to produce similar joint torques to those reported in previous studies. An anterior seat placement produced the quickest push time with the least amount of shoulder torque required. The work completed in this project demonstrates that fully predictive simulations of wheelchair propulsion have the potential of varying simulation parameters to draw meaningful conclusions.

Comparison of Peak Oxygen Uptake Between Upper-Body Exercise Modes: A Systematic Literature Review and Meta-Analysis

Purpose: To compare peak oxygen uptake (VO_2peak) between the asynchronous arm crank ergometry (ACE), and synchronous wheelchair ergometry (WERG), wheelchair treadmill (WTR), and upper-body poling (UBP) mode.

Methods: PubMed, Scopus, CINAHL, and SPORTDiscus™ were systematically searched, and identified studies screened based on title, abstract, and thereafter full-text. Studies comparing VO_2peak between ≥2 of the modes were included. A meta-analysis was performed by pooling the differences in VO_2peak between upper-body exercise modes. The quality of the included studies was assessed and the level of evidence (LoE) established for each mode comparison. Meta-regression analyses investigated the effect of total body mass and participant-related characteristics (% of able-bodied participants, % of participants with tetraplegia and % of participants who are wheelchair athletes) on differences in VO_2peak between modes.

Results: Of the 19 studies included in this review, 14 studies investigated the difference in absolute and body-mass normalized VO_2peak between ACE and WERG, and 5 studies examined the differences between ACE and WTR. No significant difference in absolute or body-mass normalized VO_2peak was found between ACE and WERG (overall effect ±95% CI: 0.01 ± 0.06 L·min⁻¹ and 0.06 ± 1.2 ml·kg⁻¹·min⁻¹, both p > 0.75; LoE: strong). No significant difference in absolute or body-mass normalized VO_2peak was found between ACE and WTR (overall effect ±95% CI: −0.10 ± 0.18 L·min⁻¹ and −1.8 ± 2.5 ml·kg⁻¹·min⁻¹, both p > 0.14; LoE: moderate). Absolute and/or body-mass normalized VO_2peak did not differ between WERG and WTR in one study with 13 participants (LoE: limited) and between ACE and UBP in one study with 18 participants (LoE: moderate). In the meta-regression analyses, there was no significant effect of the investigated factors on differences in VO_2peak.

Conclusions: The differences between the asynchronous ACE and synchronous WERG propulsion, including possible differences in trunk involvement, do not seem to influence VO_2peak. Therefore, ACE and WERG can be used interchangeably to test VO_2peak. Possible differences in VO_2peak in all other mode comparisons remain unclear due to the wide CIs and limited to moderate LoE.

Influence of wheelchair user interface and personal characteristics on static and dynamic pretibial skin pressures in elite wheelchair racers, a pilot study

Context/objective: To examine personal (athletic classification, age, sex, body mass index, duration of disability, tactile sensation of lower extremities) and wheelchair (kneeling plate angle) factors associated with increased pretibial skin pressures in elite wheelchair racers.

Design: Cross-sectional study.

Setting: University-based laboratory in Champaign, USA.

Participants: A convenience sample of elite wheelchair races with traumatic spinal cord injury and spinal disease were recruited for participation.

Interventions: Interface pressure mapping was used to examine athletes' average and peak pretibial skin pressures in their own racing wheelchairs during static and dynamic (propulsive) conditions on a dynamometer.

Outcome measures: The study examined associations between personal and wheelchair factors and pressure, differences in pressure between static and dynamic conditions, and the influence of athletic classification (T53 vs. T54) on kneeling plate angle preference and skin pressure magnitudes.

Results: Increased kneeling plate angle was moderately associated with dynamic pressures. T53 athletes utilized more vertical kneeling angles and experienced larger average and peak pressures during propulsion. Duration of disability was negatively associated with all measures of pressure. Overall, mean dynamic peak pressure was significantly greater than mean static peak pressure.

Conclusion: This pilot study represents a first step in understanding the influence of user interface on potentially injurious skin pressures in wheelchair racers. Vertical kneeling plate configurations were associated with increased pressures while increased years with disability was associated with lower pretibial pressures. In addition, T53 athletes with less trunk function may be at a greater risk for experiencing larger interface pressures than T54 athletes.

Effect of a Home-based Exercise Program on Shoulder Pain and Range of Motion in Elite Wheelchair Basketball Players: A Non-Randomized Controlled Trial

The aim of the present study was to assess the effects of a 10 week shoulder home based exercise program (SHEP) on shoulder pain (SP) and range of motion (ROM) in a group of elite wheelchair basketball (WB) players. A convenience sample of elite WB players (n = 36, 15 males and 21 females), mean age of 26 years (SD 7.6, range 15–45)) were assigned to either an exercise or a control group, according to the use of the wheelchair during daily activities. The shoulder pain index for wheelchair basketball players (SPI-WB), functional tests and ROM were measured at baseline and after a 10 week intervention. In the analysis of the SPI-WB scores, for the exercise and control groups separately, there were no significant reductions of SPI-WB scores after intervention. Related to the analysis between groups after 10 weeks of intervention, there were no significant differences in changes between the exercise and control groups (Z = 0.840, p > 0.05, r = 0.743). In this regard, there was a significant change after the intervention for shoulder extension ROM (Z = 2.81, p ≤ 0.05, r = 0.249). Shoulder Pain did not increase along the 10 weeks of the SHEP development in WB players who reported SP before the intervention program. However, in those players who started the intervention without SP, as no increase in SP was observed and players were free of injury. An exercise program could be a tool to maintain shoulder health and prevent injuries in elite WB players.

Summer Adaptive Sports Technology, Equipment, and Injuries

As adaptive sports grow in popularity, it is increasingly important to understand the injuries for which their athletes are at risk. This population is challenging to study given its small size and diversity of its participants; accordingly, research is mostly low quality because of limited sample sizes and study durations. Summer adaptive sports account for 22 of 28 Paralympic sports, with the most frequently studied being wheelchair basketball, rugby, tennis, athletics, swimming, and soccer. Injuries vary by sport because of differences in contact level, limbs utilized, and athlete impairments. Equipment changes and technological advances, especially within wheelchair and amputee sports, have increased the level of competition and reduced injury rates. Fortunately, the majority of injuries across adaptive sports are minor and do not result in significant time off from sport. Still, even minor injuries can negatively impact these athletes' mobility and activities of daily living compared to the nondisabled population.

Shoulder Rehabilitation Protocol and Equipment Fit Recommendations for the Wheelchair Sport Athlete With Shoulder Pain

Shoulder injuries in wheelchair sport athletes is the most commonly reported injury site and can directly impact not only sport performance, but everyday function and mobility. There is abundant research on shoulder rehabilitation for able bodied athletes, but minimal specifically related to wheelchair sport athletes. The purpose of this paper is to outline an exercise protocol and wheelchair sport equipment fit guidelines based off current research and expert opinion. Further research is needed on the effectiveness of a wheelchair athlete specific shoulder rehabilitation protocol, and biomechanical analysis of ideal wheelchair sport equipment fit to reduce shoulder injury and optimize performance.

Initial Maximum Push-Rim Propulsion and Sprint Performance in Elite Wheelchair Rugby Players

García-Fresneda, A, Carmona, G, Padullés, X, Nuell, S, Padullés, JM, Cadefau, JA, and Iturricastillo, A. Initial maximum push-rim propulsion and sprint performance in elite wheelchair rugby players. J Strength Cond Res 33(3): 857-865, 2019-Wheelchair rugby (WR) is an increasingly popular Paralympic sport; however, the evidence base supporting the validity and reliability of field tests to assess the physical condition of WR players is in its infancy. Therefore, here, we aimed to evaluate the intrasession reliability of the initial maximum push-rim propulsion (IMPRP) test and the sprint test, and to determine the relationships between IMPRP mechanical outputs and sprint performance variables. We studied 16 Spanish WR players (aged 33 ± 9 years). The maximum single wheelchair push from a stationary position and the sprint performance (i.e., times for 3, 5, and 12 m, and the maximum velocity) of elite WR players were measured in this study. The intraclass correlation coefficient, coefficient of variation, and standard error of measurement for IMPRP variables were >0.85, <10.6%, and <16.76, respectively; the corresponding values for a linear sprint were >0.97, <3.50%, and <0.15. In relation to IMPRP mechanical outputs (i.e., acceleration, maximum acceleration, force, maximum force, power, and maximum power) and sprint performance (i.e., times for 3, 5, and 12 m, and the maximum velocity), significant and large associations were observed in the WR players (r ± confidence limit = -0.78 ± 0.17 to -0.90 ± 0.11; 0/0/100, most likely; R = 0.613-0.812; p < 0.001). These tests provide simple and reliable methods for obtaining accurate mechanical pushing capacities and sprint performances of WR competitors (the 61.4-80.1% variance in sprint performance was explained by the IMPRP variables). These relationships indicate a need to implement specific strength exercises in WR players with the aim of improving the IMPRP and therefore improving sprint capacity.