Kwarciak Andrew M, Turner Jeffrey T, Guo Liyun, Richter W Mark
Biomechanics Laboratory, MAX Mobility, LLC, Antioch, TN 37013, USA.
Disabil Rehabil Assist Technol. 2012 Nov;7(6):459-63. doi: 10.3109/17483107.2011.650781. Epub 2012 Feb 1.
To evaluate the effects of stroke pattern on handrim biomechanics and upper limb electromyography (EMG) in experienced wheelchair users.
Subjects propelled their own wheelchair on a level, motor-driven treadmill using each of four identified stroke patterns: arcing, double loop (DL), semi-circular (SC) and single loop (SL). Upper limb EMG and measurements taken from an instrumented wheelchair wheel were compared for each pattern. A one-way ANOVA with Bonferroni correction (p < 0.05) was used to check for significant differences.
The DL and SC patterns produced the best overall results. The DL pattern led to a significantly longer contact angle and significantly less braking moment than the SL and arcing patterns, and a significantly lower cadence than the SL pattern. The SC pattern led to a significantly longer contact angle than the SL pattern and the lowest peak force and impact of any pattern. There were no significant differences in integrated EMG (IEMG); however, the DL and arcing patterns produced lower combined IEMG values.
When traversing level terrain, wheelchair users should push with either the DL or SC patterns. Between the two, the DL pattern required less muscle activity and may be a better choice for experienced wheelchair users.
评估中风模式对有经验的轮椅使用者手轮圈生物力学和上肢肌电图（EMG）的影响。
受试者在水平的电动跑步机上使用四种已确定的划圈模式（弧形、双圈（DL）、半圆形（SC）和单圈（SL））推动自己的轮椅。比较每种模式下的上肢肌电图和从装有仪器的轮椅轮上获取的测量数据。采用带有Bonferroni校正的单因素方差分析（p < 0.05）来检验显著差异。
DL和SC模式产生了最佳的总体结果。与SL和弧形模式相比，DL模式导致接触角显著更长，制动力矩显著更小，且步频显著低于SL模式。与SL模式相比，SC模式导致接触角显著更长，且在所有模式中峰值力和冲击力最低。积分肌电图（IEMG）无显著差异；然而，DL和弧形模式产生的IEMG综合值较低。
在平坦地形上行驶时，轮椅使用者应采用DL或SC模式推动。在这两种模式之间，DL模式所需的肌肉活动较少，可能是有经验的轮椅使用者的更好选择。
