Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
J Neuroeng Rehabil. 2018 Jun 26;15(1):56. doi: 10.1186/s12984-018-0397-4.
Regular handrim wheelchair (RHW) propulsion is straining for the upper extremities and wheelchair users often experience overuse problems. A recent advancement in wheelchair technology that could assist users is the pushrim-activated power-assisted wheelchair (PAPAW). PAPAWs are challenging to control, yet it is unclear how people learn to use a PAPAW. The purpose of this study is to examine early skill acquisition through practice in PAPAWs and compare it with RHWs.
Twenty-four able-bodied novices were randomly allocated to either the RHW group or the PAPAW group. The experiment consisted of five sessions with three blocks of 4 min steady-state practice at 1.11 m/s and 0.21 W/kg. Finally, a transfer to the other mode was made. Data were collected with a drag-test, breath-by-breath spirometry, and a motion capture system. The last minute of each four-minute block was used for analysis. A mixed analysis of variance (ANOVA) was used to test for group, time, and interaction effects.
Both groups improved their (assisted) mechanical efficiency, reduced their stroke rate, right-left and forward-backward deviation on the treadmill, and had a lower rate of perceived exertion (RPE) over time. (Assisted) mechanical efficiency was higher for the PAPAW group than for the RHW group and RPE was lower. However, left-right and forward-backward deviation was also found to be higher in the PAPAW group.
At the group level the energetic cost of RHW and PAPAW propulsion can be lowered through low-intensity practice in novice users. The PAPAW is more 'efficient' than the RHW given the reduced energy requirement of the user from the motor assist, but more difficult to control. Future studies on PAPAWs should focus on the control needs of the user and their interaction with the power-assist technology.
常规手推轮椅（RHW）推进对上肢有很大的压力，轮椅使用者经常会出现过度使用的问题。最近轮椅技术的一项进步可以帮助使用者，即推把激活的动力辅助轮椅（PAPAW）。PAPAW 很难控制，但人们如何学习使用 PAPAW 还不清楚。本研究的目的是通过 PAPAW 练习来检查早期技能的获得，并将其与 RHW 进行比较。
24 名健康新手被随机分配到 RHW 组或 PAPAW 组。实验包括五个阶段，每个阶段有三个 4 分钟的稳态练习块，速度为 1.11 米/秒，功率为 0.21 瓦/公斤。最后，进行了模式转换。使用阻力测试、逐口气呼吸描记法和运动捕捉系统收集数据。每个四分钟块的最后一分钟用于分析。使用混合方差分析（ANOVA）来测试组间、时间和交互作用的影响。
两组都提高了（辅助）机械效率，降低了划频，在跑步机上的左右和前后偏差，以及随着时间的推移，感觉用力的程度（RPE）降低。（辅助）机械效率 PAPAW 组高于 RHW 组，RPE 较低。然而，PAPAW 组的左右和前后偏差也较高。
在组水平上，通过新手使用者的低强度练习，可以降低 RHW 和 PAPAW 推进的能量消耗。由于马达辅助减少了使用者的能量需求，PAPAW 比 RHW 更“高效”，但更难控制。未来关于 PAPAW 的研究应侧重于使用者的控制需求及其与动力辅助技术的相互作用。
