IF WE HAD ANY STOKE LEADERSHIP AT ALL, there would be research on this for stroke survivors, proving once and for all that handrim wheelchair propulsion is completely stupid for survivors.
Maybe these and you get massive amounts of arm and hand exercises using them. Why is your stroke hospital so fucking incompetent they can't see the usefulness of them?
lever wheelchair (8 posts to May 2016)
rowing wheelchair (5 posts to May 2016)
The latest here:
Physiological and biomechanical comparison of overground, treadmill, and ergometer handrim wheelchair propulsion in able-bodied subjects under standardized conditions
Journal of NeuroEngineering and Rehabilitation
volume 17, Article number: 136 (2020)
Abstract
Background
Handrim
wheelchair propulsion is often assessed in the laboratory on treadmills
(TM) or ergometers (WE), under the assumption that they relate to
regular overground (OG) propulsion. However, little is known about the
agreement of data obtained from TM, WE, and OG propulsion under
standardized conditions. The current study aimed to standardize velocity
and power output among these three modalities to consequently compare
obtained physiological and biomechanical outcome parameters.
Methods
Seventeen
able-bodied participants performed two submaximal practice sessions
before taking part in a measurement session consisting of 3 × 4 min of
submaximal wheelchair propulsion in each of the different modalities.
Power output and speed for TM and WE propulsion were matched with OG
propulsion, making them (mechanically) as equal as possible.
Physiological data and propulsion kinetics were recorded with a
spirometer and a 3D measurement wheel, respectively.
Results
Agreement
among conditions was moderate to good for most outcome variables.
However, heart rate was significantly higher in OG propulsion than in
the TM condition. Push time and contact angle were smaller and fraction
of effective force was higher on the WE when compared to OG/TM
propulsion. Participants used a larger cycle time and more negative work
per cycle in the OG condition. A continuous analysis using statistical
parametric mapping showed a lower torque profile in the start of the
push phase for TM propulsion versus OG/WE propulsion. Total force was
higher during the start of the push phase for the OG conditions when
compared to TM/WE propulsion.
Conclusions
Physiological
and biomechanical outcomes in general are similar, but possible
differences between modalities exist, even after controlling for power
output using conventional techniques. Further efforts towards increasing
the ecological validity of lab-based equipment is advised and the
possible impact of these differences -if at all- in (clinical) practice
should be evaluated.
Background
The
repetitive and relatively high loads on the upper-extremities during
handrim wheelchair propulsion, associated with an increased risk of pain
and pathology [1,2,3], are a continued concern addressed in wheelchair research [4, 5].
Ideally, research would assess the user during overground testing in
the environment they are daily exposed to, as this has the highest
ecological validity [5].
During overground propulsion the power output necessary at a certain
velocity is dependent on a number of uncontrollable factors such as
floor-type, slope, cross-slope and air resistance, besides individual
factors of the wheelchair-combination as a whole like weight, frontal
area tire-pressure and internal frictional losses. Moreover, there are
effects of optical flow, and additional requirements such as braking and
cornering [6].
Therefore, experimental conditions overground are difficult to control
and it can be challenging to consistently collect enough consecutive
push cycles without a sufficiently spacious laboratory environment [7].
Various
other options for conducting studies on wheelchair propulsion exist,
such as, motorized treadmills or wheelchair ergometers with each having
their own advantages and disadvantages [8].
The advantage of these lab-based systems, in general, is the better
standardization and the ability to collect multiple subsequent push
cycles, increasing data reliability [9].
However, stationary systems offer no visual flow or meaningful context
which reduces task complexity and might confound data obtained from
these methods. In fact, ergometers mostly remove the need for steering
and balancing as task elements in handrim wheelchair propulsion, making
it the most abstract measurement modality [6].
Research in gait has shown that, while treadmills are mechanically valid [10], differences between overground and treadmill modalities exist [11,12,13,14,15,16,17,18,19], while others have argued that differences are minimal [14, 16, 20]. Similar studies for wheelchair propulsion, however, are lower in number and have also yielded mixed results [6, 21,22,23,24,25]. Stephens and Ensberg [25]
found that biomechanical outcome variables for overground propulsion
and treadmill propulsion were significantly different. Moreover, Chénier
et al. found that wheelchair users perceive speed differently on
treadmills compared to overground propulsion [23]. However, in different studies Kwarciak et al. [24] and Mason et al. [21]
found that physiological and biomechanical parameters in treadmill
propulsion highly correlate with overground propulsion at specific
treadmill settings. Koontz et al. [22]
also found correlations between overground and ergometer wheelchair
propulsion kinetics ranging from poor-good depending on the outcome
parameter.
A possible explanation of these mixed results could (in
part) be the lack of standardization for power output and/or speed in
those experiments. As of yet, there are no studies that compared
overground, treadmill, and ergometer wheelchair propulsion when power
output and speed are matched, even though the required methodology has
been well described and adopted in the research literature [5, 26] and is available to most labs [4]. Spatiotemporal variables are known to be dependent on factors influencing power output such as speed and slope [27]. Finally, only qualitative [22] and discrete quantitative [21, 22, 24]
comparisons have been made, whereas continuous analysis of handrim
biomechanics might also yield useful information as the biomechanical
context is immediately apparent [28].
The
goal of this study is therefore to compare the physiological,
spatiotemporal, and kinetic characteristics of wheelchair propulsion
between overground, treadmill, and ergometer handrim wheelchair
propulsion while controlling for power output and speed using available
standardization methods [26]. Results from this study can be used to better translate research to the field or to improve existing testing protocols.
Journal of NeuroEngineering and Rehabilitation volume 17, Article number: 136 (2020)
Abstract
Background
Handrim wheelchair propulsion is often assessed in the laboratory on treadmills (TM) or ergometers (WE), under the assumption that they relate to regular overground (OG) propulsion. However, little is known about the agreement of data obtained from TM, WE, and OG propulsion under standardized conditions. The current study aimed to standardize velocity and power output among these three modalities to consequently compare obtained physiological and biomechanical outcome parameters.
Methods
Seventeen able-bodied participants performed two submaximal practice sessions before taking part in a measurement session consisting of 3 × 4 min of submaximal wheelchair propulsion in each of the different modalities. Power output and speed for TM and WE propulsion were matched with OG propulsion, making them (mechanically) as equal as possible. Physiological data and propulsion kinetics were recorded with a spirometer and a 3D measurement wheel, respectively.
Results
Agreement among conditions was moderate to good for most outcome variables. However, heart rate was significantly higher in OG propulsion than in the TM condition. Push time and contact angle were smaller and fraction of effective force was higher on the WE when compared to OG/TM propulsion. Participants used a larger cycle time and more negative work per cycle in the OG condition. A continuous analysis using statistical parametric mapping showed a lower torque profile in the start of the push phase for TM propulsion versus OG/WE propulsion. Total force was higher during the start of the push phase for the OG conditions when compared to TM/WE propulsion.
Conclusions
Physiological and biomechanical outcomes in general are similar, but possible differences between modalities exist, even after controlling for power output using conventional techniques. Further efforts towards increasing the ecological validity of lab-based equipment is advised and the possible impact of these differences -if at all- in (clinical) practice should be evaluated.
Background
The repetitive and relatively high loads on the upper-extremities during handrim wheelchair propulsion, associated with an increased risk of pain and pathology [1,2,3], are a continued concern addressed in wheelchair research [4, 5]. Ideally, research would assess the user during overground testing in the environment they are daily exposed to, as this has the highest ecological validity [5]. During overground propulsion the power output necessary at a certain velocity is dependent on a number of uncontrollable factors such as floor-type, slope, cross-slope and air resistance, besides individual factors of the wheelchair-combination as a whole like weight, frontal area tire-pressure and internal frictional losses. Moreover, there are effects of optical flow, and additional requirements such as braking and cornering [6]. Therefore, experimental conditions overground are difficult to control and it can be challenging to consistently collect enough consecutive push cycles without a sufficiently spacious laboratory environment [7].
Various other options for conducting studies on wheelchair propulsion exist, such as, motorized treadmills or wheelchair ergometers with each having their own advantages and disadvantages [8]. The advantage of these lab-based systems, in general, is the better standardization and the ability to collect multiple subsequent push cycles, increasing data reliability [9]. However, stationary systems offer no visual flow or meaningful context which reduces task complexity and might confound data obtained from these methods. In fact, ergometers mostly remove the need for steering and balancing as task elements in handrim wheelchair propulsion, making it the most abstract measurement modality [6].
Research in gait has shown that, while treadmills are mechanically valid [10], differences between overground and treadmill modalities exist [11,12,13,14,15,16,17,18,19], while others have argued that differences are minimal [14, 16, 20]. Similar studies for wheelchair propulsion, however, are lower in number and have also yielded mixed results [6, 21,22,23,24,25]. Stephens and Ensberg [25] found that biomechanical outcome variables for overground propulsion and treadmill propulsion were significantly different. Moreover, Chénier et al. found that wheelchair users perceive speed differently on treadmills compared to overground propulsion [23]. However, in different studies Kwarciak et al. [24] and Mason et al. [21] found that physiological and biomechanical parameters in treadmill propulsion highly correlate with overground propulsion at specific treadmill settings. Koontz et al. [22] also found correlations between overground and ergometer wheelchair propulsion kinetics ranging from poor-good depending on the outcome parameter.
A possible explanation of these mixed results could (in part) be the lack of standardization for power output and/or speed in those experiments. As of yet, there are no studies that compared overground, treadmill, and ergometer wheelchair propulsion when power output and speed are matched, even though the required methodology has been well described and adopted in the research literature [5, 26] and is available to most labs [4]. Spatiotemporal variables are known to be dependent on factors influencing power output such as speed and slope [27]. Finally, only qualitative [22] and discrete quantitative [21, 22, 24] comparisons have been made, whereas continuous analysis of handrim biomechanics might also yield useful information as the biomechanical context is immediately apparent [28].
The goal of this study is therefore to compare the physiological, spatiotemporal, and kinetic characteristics of wheelchair propulsion between overground, treadmill, and ergometer handrim wheelchair propulsion while controlling for power output and speed using available standardization methods [26]. Results from this study can be used to better translate research to the field or to improve existing testing protocols.
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