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Determining and Controlling External Power Output During Regular Handrim Wheelchair Propulsion
Published on: February 5, 2020
Utilizing research in wheelchair and seating selection and configuration for children with injury/dysfunction of the
Christin Hasara Krey1, Christina L Calhoun
1Department of Rehabilitation, Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA. ckrey@shrinenet.org
Insights
Research on wheelchair and seating for adults with spinal cord injury (SCI) is extensive, but specific studies for pediatric SCI patients are lacking. Tailoring assessments to children's unique needs is crucial for effective wheelchair selection.
Area of Science:
- Rehabilitation Medicine
- Biomedical Engineering
- Pediatric Care
Background:
- Adult spinal cord injury (SCI) research provides a foundation for wheelchair and seating selection.
- Existing research often extrapolates findings to pediatric populations without specific validation.
- Pediatric SCI presents unique developmental and functional considerations for mobility device prescription.
Purpose of the Study:
- To evaluate the applicability of existing wheelchair and seating research to pediatric SCI.
- To identify gaps in knowledge regarding pediatric-specific wheelchair and seating configurations.
- To emphasize the need for tailored approaches in pediatric SCI mobility solutions.
Main Methods:
- Comprehensive literature reviews on powered mobility, manual wheelchair configuration, and cushion selection.
- Comparison of literature findings with clinical observations from a specialized pediatric seating clinic.
- Analysis of research on propulsion ergonomics, biomechanics, and pressure management.
Main Results:
- Significant research exists on adult SCI propulsion ergonomics and biomechanics.
- Limited research was identified concerning cushion selection and power mobility configuration for pediatric SCI.
- Current practices often apply adult-derived conclusions to pediatric cases.
Conclusions:
- There is a notable lack of SCI-specific research for pediatric wheelchair and seating.
- Findings from adult SCI research require careful adaptation for pediatric use.
- Future research must address the unique needs of young individuals with SCI for optimal outcomes.
Objective:
To determine how research regarding wheelchair and seating selection and configuration could be applied to the pediatric population with spinal cord injury (SCI) and dysfunction.
Methods:
Extensive literature reviews were completed on (a) powered mobility options and age-appropriateness for training; (b) manual wheelchair configuration, pushrim biomechanics, and propulsion ergonomics; and (c) cushion selection and use of pressure-mapping devices. The findings in the literature review then were compared with clinical observations from Shriners Hospitals for Children, Philadelphia's Seating and Wheelchair Clinic.
Results/Discussion:
A significant amount of research is published on propulsion ergonomics and pushrim biomechanics in adults with SCI. However, this literature review noted that there was limited research available on cushion selection and power mobility configuration. Many of the conclusions drawn from these publications are applied to pediatric patients and used during the decision-making process of wheelchair and cushion selection. However, it is critical to tailor the assessment to the pediatric population to meet their medical and functional needs.
Conclusion:
Although some of the findings can be correlated to the pediatric population, there is a lack of research on wheelchair and seating selection and configuration as it specifically relates to the young person with SCI and dysfunction. Future studies need to be completed.
