A Systematic Methodology to Analyze the Impact of Hand-Rim Wheelchair Propulsion on the Upper Limb

Abstract

Objective: To design and test a methodology to compare kinematic and kinetic variables of the upper limb joints when propelling different wheelchairs, and to analyze the differences between paraplegic and tetraplegic patients. Methods: Ten adults with spinal cord injury (five with paraplegia and five with tetraplegia) propelled two different wheelchairs on a treadmill at a constant speed for three minutes, with one minute break between tests. Kinematic and kinetic data of the upper limb and the hand-rim were recorded and processed using a customized software. Results: Significant differences were found between paraplegic and tetraplegic patients in the forces and moments applied on the hand-rim and the upper limb joints, especially on the shoulder. The type of wheelchair also affected the biomechanical load on the upper limb, with a lighter wheelchair reducing the impact on the shoulder of tetraplegic patients. Conclusion: The proposed methodology is suitable for kinematic and kinetic studies on wheelchair propulsion, and can be used to assess the effect of different wheelchair configurations and lesion characteristics on the upper limb biomechanics