Cooper Rory A
Department of Rehabilitation Science & Technology, University of Pittsburgh, Forbes Tower, Pittsburgh, Pennsylvania 15260, USA.
Prosthet Orthot Int. 2009 Sep;33(3):198-209. doi: 10.1080/03093640903082126.
Wheelchair prescription is complex with thousands of choices and options. Theoretically, a higher quality or innovative wheelchair that is appropriately matched to the user and their unique needs will increase participation. It is well accepted that there is an alarmingly high incidence of carpal tunnel syndrome, and rotator cuff injuries among manual wheelchair users. Since the initial conceptualization, the SMART(Wheel) was intended to better understand the physiological and physical effects of wheelchair propulsion on the body. Initially, little was known about wheelchair propulsion and the SMART(Wheel) transformed the nascent field of wheelchair propulsion biomechanics. Although still an important area of clinical research, the SMART(Wheel) has been critical to the study of the relationship between the type of wheelchair, set-up, activity, technique, anatomy, and physiology and repetitive strain injury. There has been growing evidence that the wheelchair-user interaction explains a substantial portion of the risk of developing a degenerative injury and on community participation. A noteworthy contribution of this work was the release of the clinical practice guideline, entitled, Preservation of Upper Limb Function Following Spinal Cord Injury in 2005. The SMART(Wheel) has been used by other scientists in areas that were not originally envisioned to be applications. It has been used to support the design of tools for developing a trail mapping rating and description system. It has also supported the design of accessible pedestrian walkways standards, accessible playground surfaces, and to evaluate carpets for wheelchair accessibility. It is likely that there are more new areas of exploration to emerge. This article describes the evolution of the SMART(Wheel) as new technologies became available and its applications in the field of wheelchair biomechanics and clinical service delivery.
轮椅处方很复杂，有数千种选择。从理论上讲，一款质量更高或更具创新性且能与使用者及其独特需求相匹配的轮椅，将提高其参与度。众所周知，手动轮椅使用者中腕管综合征和肩袖损伤的发病率高得惊人。自最初构思以来，SMART（Wheel）旨在更好地了解轮椅推进对身体的生理和物理影响。最初，人们对轮椅推进了解甚少，而SMART（Wheel）改变了轮椅推进生物力学这一新兴领域。尽管它仍是临床研究的一个重要领域，但SMART（Wheel）对于研究轮椅类型、设置、活动、技术、解剖学、生理学与重复性劳损损伤之间的关系至关重要。越来越多的证据表明，轮椅与使用者的相互作用在很大程度上解释了发生退行性损伤的风险以及对社区参与的影响。这项工作的一个值得注意的贡献是在2005年发布了题为《脊髓损伤后上肢功能的保留》的临床实践指南。其他科学家在一些最初并未设想的应用领域也使用了SMART（Wheel）。它被用于支持开发步道地图评级和描述系统的工具设计。它还支持无障碍行人通道标准、无障碍游乐场地面的设计，并用于评估轮椅可通行性的地毯。很可能还会出现更多新的探索领域。本文描述了随着新技术的出现SMART（Wheel）的发展历程及其在轮椅生物力学和临床服务提供领域的应用。
