Abstract
Background
Biomechanical studies have linked the handrim wheelchair propulsion with a prevalence
of upper limb musculoskeletal disorders. The purpose of this study was to examine
the influence of the wheelchair settings on upper limb kinematics during wheelchair
propulsion. Recordings were made under various wheelchair configuration conditions
to understand the effect of wheelchair settings on kinematics parameters such shoulder,
elbow and wrist angles.
Methods
Ten experts and ten beginners’ subjects propelled an experimental wheelchair on a
roller ergometer system at a comfortable speed. Twelve wheelchair configurations were
tested. Kinematics were recorded for each configuration. Based on the hand position
relatively to the handrim, the main kinematic parameters of wheelchair propulsion
were investigated on the whole propulsion cycle and a key event such as handrim contact
and release.
Findings
Compared to the beginner subjects, all the experts’ subjects generally present higher
joint amplitude and propulsion speeds. Seat height and antero-posterior axle position
influence usage of the hand-rim, timing parameters and configurations of upper limb
joints. Results seem to confirm that low and backward seat position allow a greater
efficiency. Nevertheless, according that proximity of joint limit is a well known
factor of musculoskeletal disorders, our results let us think that too low and backward
seat position, increasing joints positions and amplitudes, could increase the risk
of upper limb injuries in relation with manual wheelchair propulsion.
Interpretation
Kinematic differences highlight that future studies on wheelchair propulsion should
only be done with impaired experienced subjects. Furthermore, this study provides
indications on how wheelchair settings can be used for upper limb injury prevention.
Keywords
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Article info
Publication history
Published online: August 16, 2011
Accepted:
July 19,
2011
Received:
February 2,
2011
Identification
Copyright
© 2011 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
