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      Wheelchairs propulsion analysis: review Translated title: Análise da propulsão em cadeira de rodas manual: revisão de literatura

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          Abstract

          OBJECTIVES: To analyze aspects related with wheelchair propulsion. MATERIALS AND METHODS: In order to delineate this review the search for information was carried out within electronics databases, using the following descriptors: "wheelchair propulsion", "wheelchair biomechanics" e "wheelchair users". Full papers published in English and French were included in the study. RESULTS: The wheelchair propulsion is a complex movement that requires the execution of repeated bi manual forces applications during a short time period. In this movement high levels of force must be produced due to the bad mechanical performance of the wheelchair. Could be characterized that wheelchair users are not satisfied with their wheelchair, the places are not adapted to their presence and lack of specific criteria for the adjustment of this equipment. The main points to look at are the seat height in relation to elbow flexion (100-120 degrees) with his hand in the propulsion rim and tire pressure. The semicircular mode of technique propulsion seems to be more appropriate; in this pattern the wheelchair user returns his hand under the rim after propulsion. Efforts in wheelchairs are high and the incidence of injuries in wheelchair users is high. CONCLUSION: One can conclude that in spite of researchers’ efforts there are still many divergences between topics and methods of evaluation, what makes difficult to apply the experimental results to the wheelchairs users’ daily life.

          Translated abstract

          OBJETIVOS: Analisar aspectos relacionados à propulsão em cadeira de rodas. MATERIAIS E MÉTODOS: Para o delineamento desta revisão, foi realizada uma busca em bases de dados eletrônicas a partir das seguintes palavras-chave: wheelchair propulsion, wheelchair biomechanics e wheelchair uses. Foram selecionados artigos completos nas línguas francesa e inglesa. RESULTADOS: A propulsão em cadeira de rodas é um movimento complexo que requer a execução de repetidas aplicações de força durante curto período de tempo. Nesse movimento são exigidos altos níveis de força em razão do baixo rendimento mecânico da cadeira. Pôde ser caracterizado que os cadeirantes não estão satisfeitos com suas cadeiras, os locais não estão adaptados à sua presença e faltam critérios específicos para o ajuste desse importante equipamento. Os principais pontos a serem observados, quanto aos ajustes, são a altura do banco em relação à posição de flexão do cotovelo (100 a 120 graus) com a mão no aro de propulsão e o cuidado com a pressão nos pneus. Quanto à técnica de propulsão, o modo semicircular parece ser o mais indicado, pois nesse padrão o cadeirante realiza a propulsão e retorna a mão por baixo do aro. Os esforços na cadeira de rodas são altos e a incidência de lesões em cadeirantes é elevada. CONCLUSÃO: Pode-se concluir que, apesar dos esforços das pesquisas, ainda existem muitas divergências entre os temas e os métodos de avaliações adotados, o que impede que boa parte dos resultados encontrados seja aplicável à vida diária dos usuários de cadeira de rodas.

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          Most cited references41

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          Mechanical load on the upper extremity during wheelchair activities.

          To determine the net moments on the glenohumeral joint and elbow joint during wheelchair activities. Kinematics and external forces were measured during wheelchair activities of daily living (level propulsion, riding on a slope, weight-relief lifting, reaching, negotiating a curb) and processed in an inverse dynamics biomechanic model. Biomechanics laboratory. Five able-bodied subjects, 8 subjects with paraplegia, and 4 subjects with tetraplegia. Not applicable. Net moments on the glenohumeral joint and elbow joint. Peak shoulder and elbow moments were significantly higher for negotiating a curb and weight-relief lifting than for reaching, level propulsion, and riding on a slope. Overall, the elbow extension moments were significantly lower for subjects with tetraplegia than for those with paraplegia. The net moments during weight-relief lifting and negotiating a curb were high when compared with wheelchair propulsion tasks. Taking the effect of frequency and duration into account, these loads might imply a considerable risk for joint damage in the long term.
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            Wheelchair propulsion technique and mechanical efficiency after 3 wk of practice.

            Differences in gross mechanical efficiency between experienced and inexperienced wheelchair users may be brought about by differences in propulsion technique. The purpose of this experiment was to study changes in propulsion technique (defined by force application, left-right symmetry, intercycle variability, and timing) and gross mechanical efficiency during a 3-wk wheelchair practice period in a group of novice able-bodied nonwheelchair users. Subjects were randomly divided over an experimental group (N = 10) and a control group (N = 10). The experimental group received a 3-wk wheelchair practice period (3.wk-1, i.e., 9 practice trials) on a computer-controlled wheelchair ergometer, whereas the control group only participated in trials 1 and 9. During all nine practice trials, propulsion technique variables and mechanical efficiency were measured. No significant differences between the groups were found for force application, left-right symmetry, and intercycle variability. The push frequency and negative power deflection at the start of the push phase diminished significantly in the experimental group in contrast to the control group (P < 0.05). Work per cycle, push time, cycle time, and mechanical efficiency increased. The practice period had a favorable effect on some technique variables and mechanical efficiency, which may indicate a positive effect of improved technique on mechanical efficiency. Although muscle activation and kinematic segment characteristics were not measured in the present study, they may also impact mechanical efficiency. No changes occurred over time in most force application parameters, left-right symmetry, and intercycle variability during the 3-wk practice period; however, these variables may change on another time scale.
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              Censo 2000

              (2025)
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                Author and article information

                Journal
                fm
                Fisioterapia em Movimento
                Fisioter. mov.
                Pontifícia Universidade Católica do Paraná (Curitiba, PR, Brazil )
                1980-5918
                March 2012
                : 25
                : 1
                : 185-194
                Affiliations
                [01] La Garde orgnameUniv Lille Nord de France France sagawajunior@ 123456yahoo.com.br
                [02] Florianópolis SC orgnameUniversidade do Estado de Santa Catarina Brasil dedsnet@ 123456yahoo.com.br
                [03] Florianópolis SC orgnameUDESC Brasil d2ngbj@ 123456udesc.br
                [05] La Garde orgnameUniv Lille Nord de France France eric.watelain@ 123456univ-valenciennes.fr
                [04] Florianópolis SC orgnameUDESC Brasil danisantos82@ 123456yahoo.com.br
                Article
                S0103-51502012000100018 S0103-5150(12)02500118
                8d9f1996-f9b8-491a-a844-d8aa8f797460

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 23 May 2011
                : 02 February 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 41, Pages: 10
                Product

                SciELO Brazil

                Categories
                Review Articles

                Wheelchair,Reabilitação,Lesão,Instrumentação,Cadeiras de rodas,Rehabilitation,Lesion,Instrumentation

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