Shoulder kinetics during start-up and propulsion with a manual wheelchair within the initial phase of uninstructed training
Résumé
Purpose: Wheelchair locomotion is constraining for the upper limbs and involves a set of motor tasks
that need to be learnt by a novice user. To understand this integration process, we investigated the evolution
of shoulder kinetics during start-up and propulsion within the initial phase of low-intensity uninstructed
training.
Materials and methods: Seventeen novice able-bodied subjects performed a 120-min uninstructed practice
distributed over 4 weeks. During the initial and final sessions, upper limbs kinematics and hand-rim
kinetics were continuously collected. Inverse kinematics and dynamics coupled to a three-dimensional
linked-segment model were used to compute shoulder net moments.
Results: Participants increased the speed of the wheelchair with practice. In average, an increase of shoulder
net moments and mechanical work during the push phase was observed. Conversely, during the
recovery phase, participants slightly increased shoulder power but maintained a similar level of shoulder
loading. However, individual evolutions allowed the definition of two groups defined as: “increasers”, who
increased shoulder loading and mechanical work versus “decreasers”, who managed to limit shoulder
loading while improving the wheelchair speed.
Conclusion: These findings underline that individual adaptation strategies are essential to take into
account when designing a rehabilitation protocol for wheelchair users.
Domaines
Sciences de l'ingénieur [physics]Origine | Fichiers produits par l'(les) auteur(s) |
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