Błażkiewicz Michalina, Wiszomirska Ida, Fiok Krzysztof, Mróz Anna, Kosmol Andrzej, Mikicin Mirosław, Molik Bartosz, Marszałek Jolanta
Józef Piłsudski University of Physical Education, Faculty of Rehabilitation, Warsaw, Poland.
USA University of Central Florida,Industrial Engineering & Management Systems, USA.
Acta Bioeng Biomech. 2019;21(3):67-74.
The aim of this study was to compare the activity of upper limb muscles during hand rim wheelchair propulsion and lever wheelchair propulsion at two different velocity levels.
Twenty male volunteers with physical impairments participated in this study. Their task was to push a lever wheelchair and a hand rim wheelchair on a mechanical wheelchair treadmill for 4 minutes at a speed of 3.5 km/h and 4.5 km/h in a flat race setting (conditions of moving over flat terrain). During these trials, activity of eight muscles of upper limbs were examined using surface electromyography.
The range of motion in the elbow joint was significantly higher in lever wheelchair propulsion (59.8 ± 2.43°) than in hand rim wheelchair propulsion (43.9 ± 0.26°). Such values of kinematics resulted in a different activity of muscles. All the muscles were more active during lever wheelchair propulsion at both velocity levels. The only exceptions were extensor and flexor carpi muscles which were more active during hand rim wheelchair propulsion due to the specificity of a grip. In turn, the examined change in the velocity (by 1 km/h) while moving over flat terrain also caused a different EMG timing of muscle activation depending on the type of propulsion.
Lever wheelchair propulsion seems to be a good alternative to hand rim wheelchair propulsion owing to a different movement technique and a different EMG timing of muscle activity. Therefore, we believe that lever wheelchair propulsion should serve as supplement to traditional propulsion.
本研究旨在比较在两种不同速度水平下，上肢肌肉在轮圈式轮椅推进和杠杆式轮椅推进过程中的活动情况。
20名身体有损伤的男性志愿者参与了本研究。他们的任务是在机械轮椅跑步机上，以3.5公里/小时和4.5公里/小时的速度，在平坦赛道环境（在平坦地形上移动的条件）下，分别推动杠杆式轮椅和轮圈式轮椅4分钟。在这些试验过程中，使用表面肌电图检查上肢8块肌肉的活动情况。
杠杆式轮椅推进时肘关节的活动范围（59.8±2.43°）显著高于轮圈式轮椅推进时（43.9±0.26°）。这样的运动学数值导致了肌肉活动的差异。在两个速度水平下，杠杆式轮椅推进时所有肌肉都更活跃。唯一的例外是腕伸肌和腕屈肌，由于握法的特殊性，在轮圈式轮椅推进时它们更活跃。反过来，在平坦地形上移动时速度变化（每小时1公里），也会根据推进方式的不同导致肌肉激活的肌电图时间不同。
由于运动技术和肌肉活动的肌电图时间不同，杠杆式轮椅推进似乎是轮圈式轮椅推进的一个很好的替代方式。因此，我们认为杠杆式轮椅推进应该作为传统推进方式的补充。
