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对于一名脊髓损伤患者,使用辅助行动犬可减少手动轮椅上坡时上肢的用力。

Using a mobility assistance dog reduces upper limb effort during manual wheelchair ramp ascent in an individual with spinal cord injury.

作者信息

Gagnon Dany, Blanchet Marie, Martin-Lemoyne Valérie, Vincent Claude, Routhier François, Corriveau Hélène

机构信息

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut de Réadaptation Gingras-Lindsay-de-Montréal, Canada; and School of Rehabilitation, Université de Montréal, Montreal, Canada.

Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de Réadaptation en Déficience Physique de Québec, Quebec, Canada; and Department of Rehabilitation, Université Laval, Quebec, Canada.

出版信息

J Spinal Cord Med. 2013 Nov;36(6):700-6. doi: 10.1179/2045772313Y.0000000110. Epub 2013 Apr 12.

Abstract

OBJECTIVE

To compare the mechanical and muscular efforts generated in the non-dominant upper limb (U/L) when ascending a ramp with and without the use of a mobility assistance dog (AD(Mob)) in a manual wheelchair user with a spinal cord injury.

METHOD

The participant ascended a ramp at natural speed using his personal wheelchair with (three trials) and without (three trials) his AD(Mob). Movement parameters of the wheelchair, head, trunk, and non-dominant U/L (i.e. hand, forearm, and arm segments) were recorded with a motion analysis system. The orthogonal force components applied on the hand rims by the U/Ls were computed with instrumented wheels. Muscular activity data of the clavicular fibers of the pectoralis major, the anterior fibers of the deltoid, the long head of the biceps brachii, and the long head of the triceps brachii were collected at the non-dominant U/L.

RESULTS

During uphill propulsion with the AD(Mob), the total and tangential forces applied at the non-dominant handrim, along with the rate of rise of force, were reduced while mechanical efficiency was improved compared to uphill propulsion without the AD(Mob). Similarly, the resultant net joint movements (wrist, elbow, and shoulder) and the relative muscular demands (biceps, triceps, anterior deltoid, pectoralis major) decreased during uphill propulsion with an AD(Mob) versus without an AD(Mob).

CONCLUSION

Propelling uphill with the assistance of an AD(Mob) reduces U/L efforts and improves efficiency compared to propelling uphill without its assistance in a manual wheelchair user with a spinal cord injury.

摘要

目的

比较脊髓损伤的手动轮椅使用者在使用和不使用移动辅助犬(AD(Mob))的情况下,在上坡时非优势上肢(U/L)产生的机械力和肌肉力量。

方法

参与者使用其个人轮椅,分别在有(三次试验)和没有(三次试验)AD(Mob)的情况下以自然速度上坡。用运动分析系统记录轮椅、头部、躯干和非优势U/L(即手部、前臂和臂部节段)的运动参数。通过装有仪器的轮子计算U/L施加在轮椅手轮上的正交力分量。在非优势U/L处收集胸大肌锁骨纤维、三角肌前纤维、肱二头肌长头和肱三头肌长头的肌肉活动数据。

结果

与没有AD(Mob)的上坡推进相比,在有AD(Mob)的上坡推进过程中,施加在非优势手轮上的总力和切向力以及力的上升速率降低,而机械效率提高。同样,与没有AD(Mob)相比,在有AD(Mob)的上坡推进过程中,合成的净关节运动(腕关节、肘关节和肩关节)和相对肌肉需求(肱二头肌、肱三头肌、三角肌前束、胸大肌)减少。

结论

对于脊髓损伤的手动轮椅使用者,与没有AD(Mob)辅助的上坡推进相比,在AD(Mob)的辅助下上坡推进可减少U/L的用力并提高效率。

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