Manual wheelchair users are at considerable risk of developing upper limb overuse injuries. One preventative measure is to improve the user's push style. This project will develop the understanding required to teach proper propulsion technique. ABSTRACT Manual wheelchair propulsion is the primary mode of locomotion for millions of people around the world. Manual wheelchair users rely on their upper extremities (UE) for mobility. Pain and injury in the UE can severely impact mobility, independence and quality of life. Unfortunately, UE pain and injury is very common among manual wheelchair users. How someone pushes his wheelchair is likely related to the development of UE injuries. Despite the importance of propulsion technique, we do not know how to optimally propel a wheelchair. The reason for the lack of information is primarily due to a lack of research. The proposed project will address the need for fundamental research in wheelchair propulsion technique. The project will involve: 1) developing the instrumentation and methods required to provide real-time individually tailored propulsion technique biofeedback, 2) developing a musculoskeletal propulsion model and using it to predict the consequences of technique changes, 3) measuring the biomechanical and metabolic effects of providing biofeedback for a population of wheelchair users and 4) assessing the efficacy of repeated training sessions using an optimal biofeedback strategy. This research will fill in the gaps in our understanding, develop innovative approaches to improving technique and will demonstrate that improving propulsion technique can reduce demand on the wheelchair user. Implementation of the knowledge gained from this research is hoped to contribute to the reduction of upper extremity injuries in the wheelchair user population.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD053732-04
Application #
7840378
Study Section
Musculoskeletal Rehabilitation Sciences Study Section (MRS)
Program Officer
Shinowara, Nancy
Project Start
2007-05-20
Project End
2012-04-30
Budget Start
2010-05-01
Budget End
2011-04-30
Support Year
4
Fiscal Year
2010
Total Cost
$261,145
Indirect Cost
Name
Max Mobility, LLC
Department
Type
DUNS #
189746204
City
Antioch
State
TN
Country
United States
Zip Code
37013
Rankin, Jeffery W; Kwarciak, Andrew M; Richter, W Mark et al. (2012) The influence of wheelchair propulsion technique on upper extremity muscle demand: a simulation study. Clin Biomech (Bristol, Avon) 27:879-86
Kwarciak, Andrew M; Turner, Jeffrey T; Guo, Liyun et al. (2012) The effects of four different stroke patterns on manual wheelchair propulsion and upper limb muscle strain. Disabil Rehabil Assist Technol 7:459-63
Rankin, Jeffery W; Neptune, Richard R (2012) Musculotendon lengths and moment arms for a three-dimensional upper-extremity model. J Biomech 45:1739-44
Kwarciak, A M; Turner, J T; Guo, L et al. (2011) Comparing handrim biomechanics for treadmill and overground wheelchair propulsion. Spinal Cord 49:457-62
Rankin, Jeffery W; Richter, W Mark; Neptune, Richard R (2011) Individual muscle contributions to push and recovery subtasks during wheelchair propulsion. J Biomech 44:1246-52
Richter, W Mark; Kwarciak, Andrew M; Guo, Liyun et al. (2011) Effects of single-variable biofeedback on wheelchair handrim biomechanics. Arch Phys Med Rehabil 92:572-7
Rankin, Jeffery W; Kwarciak, Andrew M; Mark Richter, W et al. (2010) The influence of altering push force effectiveness on upper extremity demand during wheelchair propulsion. J Biomech 43:2771-9