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. 2022 Sep:142:111235.
doi: 10.1016/j.jbiomech.2022.111235. Epub 2022 Jul 26.

Hand-rim biomechanics during geared manual wheelchair propulsion over different ground conditions in individuals with spinal cord injury

Omid Jahanian  1 , Alan Gaglio  2 , Chris C Cho  3 , Vaishnavi Muqeet  4 , Roger Smith  5 , Melissa M B Morrow  6 , Elizabeth T Hsiao-Wecksler  2 , Brooke A Slavens  5
Affiliations

Hand-rim biomechanics during geared manual wheelchair propulsion over different ground conditions in individuals with spinal cord injury

Omid Jahanian et al. J Biomech. 2022 Sep.

Abstract

Geared manual wheelchair wheels, a recently developed alternative propulsion mechanism, have the potential to alleviate the high upper extremity demands required for wheelchair propulsion and help decrease the risk of secondary injuries in manual wheelchair users. The objective of this study was to investigate the effects of using geared manual wheelchairs on hand-rim biomechanics of wheelchair propulsion in individuals with spinal cord injury (SCI). Seven manual wheelchair users with SCI propelled their wheelchairs equipped with geared wheels over tile, carpet, and up a ramp in low gear (gear ratio 1.5:1) and standard gear (gear ratio 1:1) conditions. Hand-rim kinetics and stroke cycle characteristics were measured using a custom instrumented geared wheel. Using the geared wheels in the low gear condition, propulsion speed (P = 0.013), peak resultant force (P = 0.005), peak propulsive moment (P < 0.006), and peak rate of rise of the resultant force (P = 0.035) decreased significantly in comparison with the standard gear condition. The significant increase in the number of stroke cycles when normalized to distance (P = 0.004) and decrease in the normalized integrated moment (P = 0.030) indicated that although a higher number of stroke cycles are required for travelling a given distance in the low gear than the standard gear condition, the low gear condition might be less demanding for the upper extremity. These results suggest that geared wheels could be a useful technology for manual wheelchair users to independently accomplish strenuous propulsion tasks including mobility on carpeted floors and ramp ascension, while reducing the risk factors contributing to the incidence of secondary upper extremity injuries.

Keywords: Alternative propulsion mechanism; Biomechanics; Hand-rim kinetics; Manual wheelchair; Upper extremity.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Elizabeth Hsiao-Wecksler is a co-founder of IntelliWheels, Inc., the manufacturer of the geared manual wheelchair wheels that were used in this study. IntelliWheels, Inc. was sold in July 2018 and Dr. Hsiao-Wecksler is no longer involved in the company.

Figures

Figure 1.
Figure 1.
Orientation of instrumental hand rim coordinate system when the instrumented hand-rim wheel is mounted on the right side of the wheelchair.
Figure 2.
Figure 2.
Box plots and data points for speed, stroke cycle frequency, peak hand-rim resultant force, peak hand-rim propulsive moment, and peak rate of rise of hand-rim resultant force during manual wheelchair propulsion on tile and carpeted level floor and up the ramp. The bottom and top edges of the box indicate the intra-quartile range (25th and 75th percentiles). The black diamond inside the box indicates the mean value. The line inside the box indicates the median value. The value for each subject is shown with a circle and the corresponding subject number. The dashed lines are connecting the standard gear condition values with low gear condition values for each participant.
Figure 3.
Figure 3.
Box plots and data points for normalized number of stroke cycles, normalized integrated hand-rim force, and normalized integrated hand-rim propulsive moment during manual wheelchair propulsion on tile and carpeted level floor and up the ramp.
See this image and copyright information in PMC

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