Wilson-Jene Holly, Cowan Rachel, Post Rachel, Pearlman Jon
Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Physical Medicine and Rehabilitation, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
J Rehabil Assist Technol Eng. 2025 Sep 3;12:20556683251374919. doi: 10.1177/20556683251374919. eCollection 2025 Jan-Dec.
Minimizing repetitive strain (RS) is a key recommendation from clinical practice guidelines for preservation of upper limb. Propulsion force, which is required to overcome wheel rolling resistance (RR), is a major source of RS. A drum-based RR test method has been developed but has not been directly validated against propulsion forces. A previous validation study compared Drum versus treadmill RR, with excellent consistency (intraclass correlation coefficient (ICC) = 0.94) and accuracy. Drum RR system estimates (N = 192) were compared to SmartWheel RR measurements and resultant force (Fres) for multiple wheelchair setups and surfaces. We hypothesized that Drum RR will consistently predict SmartWheel RR and Fres based on ICC and accuracy based on Bland Altman limits of agreement (LOA) and coefficient of determination (R). RR ICC = 0.966, 95%CI [0.955-0.975], mean difference between methods (4.2 N), and LOA [+/-5.5 N], which varied by surface. Drum RR explained 88% (R) of SmartWheel RR variability. Drum RR prediction of Fres ICC = 0.83, 95%CI [0.77-0.87], explaining 60% of variability. Drum RR consistently predicts SmartWheel RR with excellent reliability and reasonable accuracy, and predicts Fres with good reliability and reasonable accuracy, reinforcing the validity of Drum RR for predicting system-level RR, and use guiding wheel selection to reduce RS.
将重复性劳损（RS）降至最低是上肢保护临床实践指南的一项关键建议。克服车轮滚动阻力（RR）所需的推进力是RS的主要来源。一种基于滚筒的RR测试方法已经开发出来，但尚未针对推进力进行直接验证。先前的一项验证研究比较了滚筒RR与跑步机RR，具有出色的一致性（组内相关系数（ICC）=0.94）和准确性。将滚筒RR系统的估计值（N = 192）与SmartWheel RR测量值以及多种轮椅设置和表面的合力（Fres）进行了比较。我们假设，基于ICC以及基于布兰德-奥特曼一致性界限（LOA）和决定系数（R）的准确性，滚筒RR将始终如一地预测SmartWheel RR和Fres。RR的ICC = 0.966，95%CI [0.955 - 0.975]，方法之间的平均差异为（4.2 N），LOA为[±5.5 N]，其因表面而异。滚筒RR解释了SmartWheel RR变异性的88%（R）。滚筒RR对Fres的预测ICC = 0.83，95%CI [0.77 - 0.87]，解释了60%的变异性。滚筒RR始终如一地以出色的可靠性和合理的准确性预测SmartWheel RR，并以良好的可靠性和合理的准确性预测Fres，这加强了滚筒RR在预测系统级RR方面的有效性，并有助于指导车轮选择以减少RS。
