Wheelchair Axle Position Effect on the Propulsion Performance of Persons With C7 Tetraplegia: A Repeated-Measures Study

Top Spinal Cord Inj Rehabil, 2022 · DOI: 10.46292/sci21-00043 · Published: October 1, 2022

Spinal Cord Injury Rehabilitation Biomechanics

Simple Explanation

The study examines how different wheelchair axle positions affect the speed, stroke frequency, shoulder range of motion, and acceleration during wheelchair propulsion for individuals with C7 tetraplegia. Nine participants with C7 spinal cord injury were tested using four different axle positions: forward and up, forward and down, backward and down, and backward and up. The results showed that modifying the rear axle position can improve propulsion speed and change shoulder range of motion. The forward and up position resulted in highest median speed.

Study Duration

Not specified

Participants

9 participants with C7 spinal cord injury (SCI)

Evidence Level

Level 2, Repeated-Measures Study

Key Findings

1
Significant differences in speed were observed between axle position 1 (forward and up) and position 2 (forward and down), and between position 2 and position 4 (backward and up).
2
Shoulder ROM in the sagittal plane showed a significant difference between position 2 (forward and down) and position 3 (backward and down).
3
No statistically significant differences were observed in stroke frequency or acceleration across the different axle positions.

Research Summary

This study investigates the impact of varying wheelchair axle positions on propulsion kinematics in individuals with C7 tetraplegia, focusing on speed, stroke frequency, acceleration, and shoulder range of motion. The research found that modifying the rear axle position can lead to improvements in propulsion speed and changes in shoulder ROM, with specific positions showing statistically significant differences. The authors suggest that while the differences found may not be large, they could still positively impact the lives of wheelchair users, emphasizing the importance of considering user preference alongside biomechanical factors.

Practical Implications

Clinical Practice

Healthcare professionals should consider adjusting the rear axle position to optimize propulsion speed and shoulder ROM for individuals with C7 SCI.

Wheelchair Configuration

Wheelchair prescriptions should prioritize an elbow angle between 100 and 120 degrees when the hand is at the top of the push rim, positioning the axle as far forward as possible without compromising stability.

Future Research

Further studies should investigate the effects of rear axle position changes on kinetic parameters and user preferences in individuals with C7 SCI.

Study Limitations

1
Small sample size (n = 9).
2
The seat width was not adjustable, and the backrest was the same for all participants.
3
Handrim and joint forces were not collected (i.e., kinetic parameters).

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