Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Canada.
Department of Occupational Therapy, Nova Scotia Health Authority, Halifax, Canada.
Disabil Rehabil Assist Technol. 2022 Apr;17(3):325-330. doi: 10.1080/17483107.2020.1782490. Epub 2020 Jun 27.
The aim of this study was to test the hypotheses that, during manual-wheelchair foot propulsion backward on a soft surface, lowering the seat height increases speed, push frequency and push effectiveness, and decreases perceived difficulty.
In a repeated-measures crossover study, 50 able-bodied participants used one foot to propel a manual wheelchair 5 m backward on a soft surface at 5 seat heights, ranging from 5.08 cm below to about 5.08 cm above lower-leg length, in random order. We recorded Wheelchair Skills Test (WST) capacity scores and used the Wheelchair Propulsion Test (WPT) to calculate speed (m/s), push frequency (cycles/s) and push effectiveness (m/cycle). We also recorded the participants' perceived difficulty (0-4) and video-recorded each trial.
WST capacity scores were reduced at the higher seat heights. Using repeated-measures models (adjusted for age, sex and order), there were negative relationships between seat height and speed ( < 0.0001) and push effectiveness ( < 0.0001). Lowering the seat height by 5.08 cm below lower-leg length corresponded to improvements in speed of 0.097 m/s and in push effectiveness of 0.101 m/cycle. The trend for push frequency was also significant ( = 0.035) but the effect size was smaller. Perceived difficulty increased with seat height ( < 0.0001). The video-recordings provided qualitative kinematic data regarding the seated "gait cycles".
During manual-wheelchair foot propulsion backward on a soft surface, lowering the seat height increases speed and push effectiveness, and decreases perceived difficulty.IMPLICATIONS FOR REHABILITATIONBackward wheelchair foot propulsion on soft surfaces is affected by seat height.Speed (m/s) is improved if the seat height is lowered.Push effectiveness (m/gait cycle) is improved if the seat height is lowered.Perceived difficulty of propulsion is lower if the seat height is lowered.
本研究旨在验证以下假设，即在软表面上使用手动轮椅向后进行脚蹬地推进时，降低座椅高度会增加速度、推动频率和推动效果，同时降低感知难度。
在一项重复测量交叉研究中，50 名健全参与者使用一只脚在软表面上向后推动手动轮椅 5 米，座椅高度从低于小腿长度 5.08 厘米到大约高于小腿长度 5.08 厘米不等，以随机顺序进行。我们记录了轮椅技能测试（WST）的能力得分，并使用轮椅推进测试（WPT）计算速度（m/s）、推动频率（cycles/s）和推动效果（m/cycle）。我们还记录了参与者的感知难度（0-4）并对每个试验进行视频记录。
在较高的座椅高度下，WST 能力得分降低。使用重复测量模型（根据年龄、性别和顺序进行调整），座椅高度与速度（ < 0.0001）和推动效果（ < 0.0001）呈负相关。将座椅高度降低 5.08 厘米低于小腿长度，速度提高 0.097 m/s，推动效果提高 0.101 m/cycle。推动频率的趋势也具有统计学意义（ = 0.035），但效应量较小。感知难度随座椅高度增加而增加（ < 0.0001）。视频记录提供了关于坐姿“步态周期”的定性运动学数据。
在软表面上手动轮椅向后脚蹬地推进时，降低座椅高度会增加速度和推动效果，同时降低感知难度。
在软表面上向后推动轮椅时，座椅高度会影响脚蹬地推进。降低座椅高度可以提高速度。降低座椅高度可以提高推动效果。降低座椅高度会降低推进的感知难度。
