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Determining and Controlling External Power Output During Regular Handrim Wheelchair Propulsion
Published on: February 5, 2020
Low-Intensity Wheelchair Training in Inactive People with Long-Term Spinal Cord Injury: A Randomized Controlled Trial
Jan W van der Scheer1, Sonja de Groot, Riemer J K Vegter
1From the Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, the Netherlands (JWvdS, SdG, RJKV, JH, LHVvdW); Amsterdam Rehabilitation Research Center|Reade, Amsterdam, the Netherlands (SdG); Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, the Netherlands (MT, LHVvdW); Heliomare, Rehabilitation Center, Wijk aan Zee, the Netherlands (HS); Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, the Netherlands (DHEJV); and Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, the Netherlands (DHEJV).
Objective:
The objective of this study was to investigate the effects of a low-intensity wheelchair training on propulsion technique in inactive people with long-term spinal cord injury.
Design:
Participants in this multicenter nonblinded randomized controlled trial were inactive manual wheelchair users with spinal cord injury for at least 10 yrs (N = 29), allocated to exercise (n = 14) or no exercise. The 16-wk training consisted of wheelchair treadmill propulsion at 30%-40% heart rate reserve or equivalent in rate of perceived exertion, twice a week, 30 mins per session. Propulsion technique was assessed at baseline as well as after 8, 16, and 42 wks during two submaximal treadmill-exercise blocks using a measurement wheel attached to a participant's own wheelchair. Changes over time between the groups were analyzed using Mann-Whitney U tests on difference scores (P < 0.05/3).
Results:
Data of 16 participants could be analyzed (exercise: n = 8). Significant differences between the exercise and control groups were only found in peak force after 8 wks (respective medians, -20 N vs. 1 N; P = 0.01; r(u) = 0.78).
Conclusions:
Significant training effects on propulsion technique were not found in this group. Perhaps, substantial effects require a higher intensity or frequency. Investigating whether more effective and feasible interventions exist might help reduce the population's risk of upper-body joint damage during daily wheelchair propulsion.
