Boninger M L, Cooper R A, Robertson R N, Rudy T E
Department of Orthopaedic Surgery, University of Pittsburgh, PA, USA.
Arch Phys Med Rehabil. 1997 Apr;78(4):364-72. doi: 10.1016/s0003-9993(97)90227-6.
To describe motion, forces, and moments occurring at the wrist in anatomic terms during wheelchair propulsion; to obtain variables that characterize wrist function during propulsion and are statistically stable; and to determine how these variables change with speed.
Case series.
Biomechanics laboratory.
Convenience sample of Paralympic athletes (n = 6) who use manual wheelchairs for mobility and have unimpaired arm function.
Subjects propelled a standard wheelchair on a dynamometer at 1.3m/sec and 2.2m/sec. Biomechanical data were obtained using a force and moment sensing pushrim and a motion analysis system.
Maximum angles, forces, and moments in a local, wrist coordinate system. Each variable was evaluated for stability using Cronbach's alpha. Measures found to be stable (infinity > .8) at each speed were then compared to look for differences associated with speed.
The following measures were stable at both speeds: maximum wrist flexion, ulnar deviation, and radial deviation angles, peak moments acting to cause wrist flexion, extension, and ulnar deviation, peak shear forces acting between the radial and ulnar styloids, and peak axial force acting at the wrist. Of these measures, the following measures differed (p < .05) between speeds (+/-SD): maximum radial deviation (1.3m/sec, 25.1 degrees +/- 9.0; 2.2m/sec, 21.4 degrees +/- 6.9), peak flexion moment (1.3m/ sec, 3.4N.m +/- 3.0; 2.2m/sec, 5.2N.m +/- 3.7), peak extension moment (1.3m/sec, 10.4N.m +/- 4.8; 2.2m/sec, 13.6N.m +/- 5.1), peak shear acting from the ulnar styloid to the radial styloid (1.3m/sec, 2.3N +/- 2.7, 2.2m/sec, 8.3N +/- 7.5) and maximum axial force (1.3m/sec, 50.9N +/- 18.2; 2.2m/sec, 65.9N +/- 27.6).
This study found stable parameters that characterize wrist biomechanics during wheelchair propulsion and varied with speed. Ultimately these parameters may provide insight into the cause and prevention of wrist injuries in manual wheelchair users.
用解剖学术语描述轮椅推进过程中腕部产生的运动、力和力矩；获取表征推进过程中腕部功能且统计稳定的变量；并确定这些变量如何随速度变化。
病例系列研究。
生物力学实验室。
方便抽样选取的6名残奥会运动员，他们使用手动轮椅出行且手臂功能未受损。
受试者在测力计上以1.3米/秒和2.2米/秒的速度推动标准轮椅。使用力和力矩感应轮辋及运动分析系统获取生物力学数据。
局部腕部坐标系中的最大角度、力和力矩。使用克朗巴哈系数评估每个变量的稳定性。然后比较在每个速度下稳定（系数大于0.8）的测量值，以寻找与速度相关的差异。
以下测量值在两种速度下均稳定：最大腕部屈曲、尺侧偏斜和桡侧偏斜角度，引起腕部屈曲、伸展和尺侧偏斜的峰值力矩，桡骨茎突和尺骨茎突之间的峰值剪切力，以及作用于腕部的峰值轴向力。在这些测量值中，以下测量值在不同速度间存在差异（p < 0.05）（±标准差）：最大桡侧偏斜（1.3米/秒时，25.1度±9.0；2.2米/秒时，21.4度±6.9），峰值屈曲力矩（1.3米/秒时，3.4牛·米±3.0；2.2米/秒时，5.2牛·米±3.7），峰值伸展力矩（1.3米/秒时，10.4牛·米±4.8；2.2米/秒时，13.6牛·米±5.1），从尺骨茎突到桡骨茎突的峰值剪切力（1.3米/秒时，2.3牛±2.7；2.2米/秒时，8.3牛±7.5）以及最大轴向力（1.3米/秒时，50.9牛±18.2；2.2米/秒时，65.9牛±27.6）。
本研究发现了表征轮椅推进过程中腕部生物力学且随速度变化的稳定参数。最终，这些参数可能有助于深入了解手动轮椅使用者腕部损伤的原因及预防方法。
