Dallmeijer A J, van der Woude L H, Hollander A P, van As H H
Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit Amsterdam, The Netherlands.
Med Sci Sports Exerc. 1999 Sep;31(9):1330-5. doi: 10.1097/00005768-199909000-00015.
The objective of the present study was to evaluate the effect of rehabilitation on physical capacity, mechanical efficiency of manual wheelchair propulsion, and performance of standardized activities of daily living (ADL).
Nineteen recently injured subjects with spinal cord injuries were tested on a wheelchair ergometer (maximal isometric strength, sprint and maximal power output, and peak oxygen uptake) and during standardized ADL (physical strain and performance time) at the beginning (t1) and at the end (t2) of the active rehabilitation period.
Paired Student t-tests showed significant increases for maximal isometric strength (24%, P < 0.01), sprint power output (l7%, P < 0.001) and maximal power output (38%, P < 0.001). Peak oxygen uptake showed no statistically significant improvement (11%, P = 0.06). Mechanical efficiency of submaximal wheelchair exercise was significantly higher at t2 (9.0%) compared to t1 (7.9%, P < 0.01). No significant differences were found for physical strain during ADL, except for passing a door (P < 0.05). Performance time showed a significant decrease for most tasks.
The results of this study show considerable improvements in physical capacity and mechanical efficiency of manual wheelchair propulsion during rehabilitation, and a concomitant lower performance time during standardized ADL. The higher mechanical efficiency and the decrease in performance time during standardized ADL suggest improvement in wheelchair propulsion technique.
本研究的目的是评估康复对身体能力、手动轮椅推进的机械效率以及标准化日常生活活动（ADL）表现的影响。
19名近期脊髓损伤的受试者在主动康复期开始时（t1）和结束时（t2），在轮椅测力计上进行测试（最大等长力量、短跑和最大功率输出以及峰值摄氧量），并在标准化ADL期间（身体应变和完成时间）进行测试。
配对学生t检验显示，最大等长力量显著增加（24%，P<0.01）、短跑功率输出增加（17%，P<0.001）和最大功率输出增加（38%，P<0.001）。峰值摄氧量无统计学显著改善（11%，P = 0.06）。与t1（7.9%）相比，次最大轮椅运动的机械效率在t2时显著更高（9.0%，P<0.01）。ADL期间除了通过一扇门（P<0.05）外，身体应变没有显著差异。大多数任务的完成时间显著减少。
本研究结果表明，康复期间身体能力和手动轮椅推进的机械效率有显著改善，同时标准化ADL期间的完成时间降低。标准化ADL期间较高的机械效率和完成时间的减少表明轮椅推进技术有所改进。
