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  4. Evaluation of Pediatric Manual Wheelchair Mobility Using Advanced Biomechanical Methods

Evaluation of Pediatric Manual Wheelchair Mobility Using Advanced Biomechanical Methods

BioMed Research International, 2015 · DOI: http://dx.doi.org/10.1155/2015/634768 · Published: January 1, 2015

Spinal Cord InjuryPediatricsBiomechanics

Simple Explanation

This study investigates how children with spinal cord injuries move in their manual wheelchairs. It focuses on measuring the forces and motions at the shoulder, elbow, and wrist joints to understand the physical demands on their upper bodies. Researchers used motion capture technology to track the movement of the children's upper bodies as they propelled their wheelchairs. This data was then used to calculate the forces and moments acting on their joints. The findings help identify potential risks for pain and injuries in these young wheelchair users. The research aims to improve wheelchair design, prescription, and training to minimize these risks and enhance their quality of life.

Study Duration
Not specified
Participants
12 pediatric manual wheelchair users with spinal cord injury
Evidence Level
Not specified

Key Findings

  • 1
    The glenohumeral joint (shoulder) displayed the largest average range of motion at 47.1 degrees in the sagittal plane.
  • 2
    The largest average joint forces were superiorly and anteriorly directed at the glenohumeral joint (6.1% and 6.5% of body weight, respectively).
  • 3
    The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension.

Research Summary

This study evaluated the upper extremity joint dynamics during pediatric wheelchair mobility using advanced biomechanical methods. Twelve subjects with SCI propelled their wheelchair at a self-selected speed while motion analysis captured upper extremity joint kinematics, forces, and moments. The study found that the glenohumeral joint experienced the largest range of motion and joint forces, while the largest joint moments were observed at the elbow. These high joint demands may put pediatric manual wheelchair users at risk for pain and upper limb injuries. The biomechanical methods presented in this study can be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training to minimize the risk of developing secondary complications associated with wheelchair use.

Practical Implications

Improved Wheelchair Prescription

The evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription.

Targeted Training Programs

The study supports continued quantitative evaluation of joint biomechanics for the prevention of pain and overuse injuries.

Enhanced Understanding of Injury Mechanisms

Better knowledge of how to evaluate UE dynamics during wheelchair propulsion may enhance our understanding of the onset and propagation of UE pain and secondary pathologies.

Study Limitations

  • 1
    The study did not specify the duration of the study.
  • 2
    The study acknowledges the variation of stroke patterns and speed may have impacted our group means which supports subject specific analyses in the future.
  • 3
    Further work is underway to investigate the effects of age, duration of wheelchair use, muscular and soft tissue contributions, and level of injury.

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