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Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation
Published on: March 8, 2018
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Effect of Wheelchair Stroke Pattern on Upper Extremity Muscle Fatigue.
Brittany Bickelhaupt1, Sakiko Oyama2, Jonathan Benfield3
1Department of Rehabilitation Medicine, University of Texas Health Science Center of San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229.
Summary
The semicircular (SC) arm stroke technique for wheelchair propulsion may cause more shoulder muscle fatigue than the pump (P) technique. Further research is needed to confirm this finding in individuals with spinal cord injury (SCI).
Area of Science:
- Rehabilitation Medicine
- Biomechanics
- Sports Science
Background:
- Shoulder dysfunction affects up to 63% of individuals with spinal cord injury (SCI).
- Muscle imbalances, particularly in rotator cuff muscles, contribute to shoulder dysfunction during manual wheelchair propulsion.
- Repetitive use of weakened shoulder muscles in SCI can lead to pain and limited mobility.
Purpose of the Study:
- To compare the energy efficiency of two wheelchair arm stroke techniques: pump (P) and semicircular (SC).
- To determine which technique is more sustainable for prolonged manual wheelchair propulsion.
- To investigate the impact of different propulsion techniques on shoulder muscle fatigue.
Main Methods:
- A randomized study with repeated measures was conducted.
- 18 able-bodied male participants were assigned to either the SC or P propulsion group.
- Participants propelled a wheelchair on a treadmill for 10 minutes, with shoulder muscle fatigue assessed using the Borg CR10 Rate of Perceived Exertion (Borg RPE) and upper extremity strength measured by a handheld dynamometer.
Main Results:
- While not statistically significant (P = .23), the Borg RPE scores were consistently higher for the SC technique compared to the P technique.
- Dynamometer readings showed a greater decrease in shoulder and elbow extension strength for participants using the SC technique, although this difference was not statistically significant.
- These findings suggest a trend towards increased fatigue with the SC propulsion method.
Conclusions:
- The semicircular (SC) wheelchair propulsion pattern may induce greater shoulder muscle fatigue compared to the pump (P) pattern.
- Current data suggest the SC technique is more fatiguing, but further investigation with a larger sample size is required to establish statistical significance.
- Understanding the biomechanical differences in propulsion techniques can inform strategies to mitigate shoulder injury in wheelchair users.
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