Upper extremity kinematics and kinetics during the performance of a stationary wheelie in manual wheelchair users with a spinal cord injury.

No comprehensive biomechanical study has documented upper extremity (U/E) kinematics and kinetics during the performance of wheelchair wheelies among manual wheelchair users (MWUs). The aim of this study was to describe movement strategies (kinematics), mechanical loads (kinetics), and power at the nondominant U/E joints during a wheelie among MWUs with spinal cord injury (SCI). During a laboratory assessment, 16 MWUs with SCI completed four wheelie trials on a rigid surface. Each participant's wheelchair was equipped with instrumented wheels to record handrim kinetics, while U/E and wheelchair kinematics were recorded with a 3D motion analysis system. The greatest mean and peak total net joint moments were generated by the shoulder flexors (mean = 7.2 ± 3.5 N·m; peak = 20.7 ± 12.9 N·m) and internal rotators (mean = 3.8 ± 2.2 N·m; peak = 11.4 ± 10.9 N·m) as well as by the elbow flexors (mean = 5.5 ± 2.5 N·m; peak = 14.1 ± 7.6 N·m) during the performance of wheelies. Shoulder flexor and internal rotator efforts predominantly generate the effort needed to lift the front wheels of the wheelchair, whereas the elbow flexor muscles control these shoulder efforts to reach a state of balance. In combination with a task-specific training program that remains essential to properly learn how to control wheelies among MWUs with SCI, rehabilitation professionals should also propose a shoulder flexor, internal rotator, and elbow flexor strengthening program.

[1]  R Lee Kirby,et al.  The Effect of Rolling Resistance on Stationary Wheelchair Wheelies , 2006, American journal of physical medicine & rehabilitation.

[2]  Sylvie Nadeau,et al.  Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury. , 2008, Journal of rehabilitation research and development.

[3]  R Lee Kirby,et al.  The manual wheelchair wheelie: A review of our current understanding of an important motor skill , 2006, Disability and rehabilitation. Assistive technology.

[4]  Philippe Vaslin,et al.  Upper limb joint dynamics during manual wheelchair propulsion. , 2010, Clinical biomechanics.

[5]  R Lee Kirby,et al.  Learning to perform wheelchair wheelies: comparison of 2 training strategies. , 2004, Archives of physical medicine and rehabilitation.

[6]  K. Roach,et al.  Development of the Wheelchair User's Shoulder Pain Index (WUSPI) , 1995, Paraplegia.

[7]  Bryan Buchholz,et al.  ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--Part II: shoulder, elbow, wrist and hand. , 2005, Journal of biomechanics.

[8]  Amit Gefen,et al.  The biomechanics of sitting‐acquired pressure ulcers in patients with spinal cord injury or lesions , 2007, International wound journal.

[9]  Kauzlarich Jj,et al.  A theory of wheelchair wheelie performance. , 1987 .

[10]  R. L. Kirby,et al.  Proactive balance strategy while maintaining a stationary wheelie. , 2001, Archives of physical medicine and rehabilitation.

[11]  R Dumas,et al.  A 3D Generic Inverse Dynamic Method using Wrench Notation and Quaternion Algebra , 2004, Computer methods in biomechanics and biomedical engineering.

[12]  D Gagnon,et al.  Effects of rolling resistances on handrim kinetics during the performance of wheelies among manual wheelchair users with a spinal cord injury , 2012, Spinal Cord.

[13]  Hiroshi Yamazaki,et al.  Biomechanics and Motor Control of Normal Young Adults Performing a Wheel Chair Wheelie Balance Task , 2010, Perceptual and motor skills.

[14]  H E Veeger,et al.  Load on the upper extremity in manual wheelchair propulsion. , 1991, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[15]  M. Boninger,et al.  Shoulder joint kinetics and pathology in manual wheelchair users. , 2006, Clinical biomechanics.

[16]  Laurence Chèze,et al.  Rotation sequence as an important factor in shoulder kinematics. , 2006, Clinical biomechanics.

[17]  R Lee Kirby,et al.  Neck discomfort of wheelchair users: effect of neck position , 2004, Disability and rehabilitation.

[18]  Kai-Nan An,et al.  A new method to quantify demand on the upper extremity during manual wheelchair propulsion. , 2004, Archives of physical medicine and rehabilitation.

[19]  L. V. D. van der Woude,et al.  Mechanical load on the upper extremity during wheelchair activities. , 2005, Archives of physical medicine and rehabilitation.

[20]  R L Kirby,et al.  Spotter strap for the prevention of wheelchair tipping. , 1999, Archives of physical medicine and rehabilitation.