Changes In Upper Extremity And Trunk Angular Kinematics During Power-assisted Wheelchair Use

Abstract

Two types of wheelchairs have traditionally been available to the public: manual and power. Pushrim-activated power-assisted wheels (PAWs) are an intermediate alternative. Changes in upper extremity and trunk kinematics while using PAWs have not been thoroughly explored. PURPOSE: To determine if PAWs influence upper extremity and trunk angular kinematics after prolonged use and across different surfaces. METHODS: Thirteen male and six female full-time manual wheelchair users (age 43.1±15.0 yrs) who had no musculoskeletal disorders in their upper extremities participated. Each participant was fitted with reflective markers on their upper extremities and trunk. Each participant wheeled over three different surfaces at a self-selected pace: a flat vinyl floor, a thick carpet, and a 4m long ramp inclined to 6 degrees. Kinematic data were collected during four separate visits: S1 (participants used their own manual wheelchair), S2 (participants used their own wheelchair fitted with PAWs after a few minutes of practice), S3 (participants were tested after 8 weeks of PAW use), and S4 (participants returned to their own wheelchair for 4 weeks). Each trial was recorded using seven digital cameras. Angular kinematics of the trunk (flex/ext), shoulder (flex/ext and ab/aduction), elbow (flex/ext), and wrist (flex/ext) were calculated. RESULTS: Separate two-way ANOVA (time x surface) indicated that participants utilized less elbow flexion in S3 compared to S1 and S4 (see table). As expected, wheeling up the ramp increased angular demands on the upper extremities. CONCLUSIONS: The results indicate that wheelers utilize less elbow flexion during the recovery phase after prolonged PAW use. This difference may have clinical significance.TABLE: No caption avaialable.