Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, QC, Canada.
Spinal Cord. 2013 Mar;51(3):245-51. doi: 10.1038/sc.2012.140. Epub 2012 Nov 27.
Repeated cross-sectional study.
To compare the effects of rolling resistances (RRs) on handrim kinetic intensity at the non-dominant upper limb and on handrim kinetic symmetry during wheelies performed by manual wheelchair users (MWUs) with spinal cord injury (SCI).
Pathokinesiology Laboratory.
Sixteen individuals with SCI who were able to perform wheelies participated in this study. During a laboratory assessment, participants randomly performed wheelies on four RRs: natural high-grade composite board, 5-cm thick soft foam, 5-cm thick memory foam, and with the rear wheels blocked by wooden blocks. Four trials were conducted for each of the RRs. Participant's wheelchair was equipped with instrumented wheels to record handrim kinetics, whereas the movements of the wheelchair were recorded with a motion analysis system.
The net mean and peak total forces, including its tangential and mediolateral components, were greater during take-off compared with the other phases of the wheelie, independently of RR. During take-off, the greatest net mean and peak total and tangential forces were reached with the wheels blocked. Symmetrical tangential and mediolateral force intensities were applied at the dominant and non-dominant handrims.
Wheelies performed on low or moderate density foam generate similar forces at the handrim than on a natural surface and significantly less forces than with the wheels blocked. Hence, when teaching individuals with an SCI to perform a stationary wheelie, the use of low or moderate density foam represents a valuable alternative for minimizing upper limb effort and may also optimize quasi-static postural steadiness.
重复横截面研究。
比较滚动阻力(RRs)对上肢非优势侧手轮动力学强度和脊髓损伤(SCI)患者轮椅使用者(MWUs)在进行轮式动作时手轮动力学对称性的影响。
病理运动学实验室。
16 名能够进行轮式动作的 SCI 患者参与了这项研究。在实验室评估中,参与者随机在四种 RR 上进行轮式动作:天然高等级复合板、5 厘米厚的软泡沫、5 厘米厚的记忆泡沫和用木块挡住后轮。每种 RR 进行 4 次试验。参与者的轮椅配备了仪器化的车轮来记录手轮动力学,而轮椅的运动则用运动分析系统记录。
无论 RR 如何,在起飞阶段的净平均和峰值总力(包括其切向和侧向分量)都大于轮式动作的其他阶段。在起飞阶段,用木块挡住车轮时,达到了最大的净平均和峰值总力和切向力。在优势和非优势手轮上施加了对称的切向和侧向力强度。
在低或中密度泡沫上进行的轮式动作产生的手轮力与天然表面相似,但比用木块挡住车轮时产生的力小得多。因此,在教授 SCI 患者进行固定轮式动作时,使用低或中密度泡沫是一种减少上肢用力的有价值的替代方法,也可以优化准静态姿势稳定性。