Lin Jui-Te, Sprigle Stephen
Shirley Ryan AbilityLab, Chicago, IL, USA.
School of Industrial Design, Georgia Institute of Technology, Atlanta, GA, USA.
Disabil Rehabil Assist Technol. 2020 Apr;15(3):328-335. doi: 10.1080/17483107.2019.1578425. Epub 2019 Feb 27.
The goal of this study was to evaluate the relative influence of operator and wheelchair factors on propulsion effort during over-ground wheelchair manoeuvres. This observational study included 23 full-time manual wheelchair users and 13 able-bodied subjects. The operator factors included shoulder position, aerobic capacity and propulsion strength. The wheelchair factors included system mass, weight distribution, and frictional loss in straight and turning trajectories. The performance of over-ground manoeuvres was defined as the propulsion effort measured by VO as operators propelled along a modified figure-8 course on tile and carpet surfaces. According to our regression model, shoulder position was the only significant contributor within operator factors, whereas weight distribution was the only significant contributor within wheelchair factors in influencing propulsion efforts. When combining operator and mechanical factors in the regression model, weight distribution became the only significant contributor to influence propulsion effort. Weight distribution and shoulder position had a significant influence on propulsion effort. These variables are related to the operator's relationship to the drive wheels. However, system mass and muscle strength had the least influence on wheelchair manoeuvres. Our finding can help clinicians to improve wheelchair configurations and manufacturers to improve wheelchair design by understanding the importance of shoulder position and weight distribution.Implication for rehabilitationStudying wheelchair manoeuvers by considering both wheelchair and operator factors might provide a unique insight to address the complex interactions among wheelchair designs and users.Propulsion effort decreases as percentage weight is increased on the drive wheels and the shoulder becomes more aligned with the axle position, which highlights the need to optimize wheelchair axle position.Wheelchair configuration, as represented by weight distribution, had a more significant influence on everyday manoeuvre than wheelchair mass does.It is essential for wheelchair users to choose a wheelchair that can match their daily needs and anthropometric measurements for saving propulsion efforts.
本研究的目的是评估在地面轮椅操作过程中，操作者因素和轮椅因素对推进力的相对影响。这项观察性研究纳入了23名全职手动轮椅使用者和13名健全受试者。操作者因素包括肩部位置、有氧能力和推进力量。轮椅因素包括系统质量、重量分布以及直线和转弯轨迹中的摩擦损失。地面操作的表现定义为当操作者沿着瓷砖和地毯表面上的改良8字形路线推进时，通过VO测量的推进力。根据我们的回归模型，肩部位置是操作者因素中唯一的显著影响因素，而重量分布是轮椅因素中影响推进力的唯一显著因素。当在回归模型中综合考虑操作者和机械因素时，重量分布成为影响推进力的唯一显著因素。重量分布和肩部位置对推进力有显著影响。这些变量与操作者和驱动轮之间的关系有关。然而，系统质量和肌肉力量对轮椅操作的影响最小。我们的研究结果可以帮助临床医生通过了解肩部位置和重量分布的重要性来改善轮椅配置，也可以帮助制造商改进轮椅设计。
康复意义
通过同时考虑轮椅和操作者因素来研究轮椅操作，可能会为解决轮椅设计与使用者之间复杂的相互作用提供独特的见解。
随着驱动轮上重量百分比的增加以及肩部与轴位置更加对齐，推进力会降低，这突出了优化轮椅轴位置的必要性。
以重量分布表示的轮椅配置对日常操作的影响比轮椅质量更大。
对于轮椅使用者来说，选择一款能够匹配其日常需求和人体测量数据的轮椅以节省推进力至关重要。
