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Research Papers

Comparison of Kinematics, Kinetics, and EMG Throughout Wheelchair Propulsion in Able-Bodied and Persons With Paraplegia: An Integrative Approach

[+] Author and Article Information
Sarah R. Dubowsky

Rehabilitation Engineering Analysis Laboratory, Human Performance and Movement Analysis Laboratory,  Kessler Medical Rehabilitation Research and Education Center, 1199 Pleasant Valley Way, West Orange, NJ 07052

Sue Ann Sisto

School of Health Technology & Management, Health Sciences Center, Level 2, Room 439,  Stony Brook University, Stony Brook, NY 11794-8201

Noshir A. Langrana

Biomedical Engineering, Professor, Mechanical & Aerospace Engineering, Rutgers,  The State University of New Jersey, 599 Taylor Road, Piscataway, NJ 08854

J Biomech Eng 131(2), 021015 (Dec 18, 2008) (8 pages) doi:10.1115/1.2900726 History: Received November 30, 2006; Revised September 14, 2007; Published December 18, 2008

A systematic integrated data collection and analysis of kinematic, kinetic, and electromyography (EMG) data allow for the comparison of differences in wheelchair propulsion between able-bodied individuals and persons with paraplegia. Kinematic data from a motion analysis system, kinetic data from force-sensing push rims, and electromyography data from four upper-limb muscles were collected for ten push strokes. Results are as follows: Individuals with paraplegia use a greater percentage of their posterior deltoids, biceps, and triceps in relation to maximal voluntary contraction. These persons also reached peak anterior deltoid firing nearly 10 deg earlier on the push rim, while reaching peak posterior deltoid nearly 10 deg later on the push rim. Able-bodied individuals had no triceps activity in the initial stages of propulsion while their paraplegic groups had activity throughout. Able-bodied participants also had, on average, peak resultant, tangential, and radial forces occurring later on the push rim (in degrees). There are two main conclusions that can be drawn from this integrative investigation: (1) A greater “muscle energy,” as measured by the area under the curve of the percentage of EMG throughout propulsion, results in a greater resultant joint force in the shoulder and elbow, thus potentially resulting in shoulder pathology. (2) Similarly, a greater muscle energy may result in fatigue and play a factor in the development of shoulder pain and pathology over time; fatigue may compromise an effective propulsive stroke placing undue stresses on the joint capsule. Muscle activity differences may be responsible for the observed kinematic and kinetic differences between the two groups. The high incidence of shoulder pain in manual wheelchair users as compared to the general population may be the result of such differences, although the results from this biomedical investigation should be examined with caution. Future research into joint forces may shed light on this. Further investigation needs to focus on whether the pattern of kinematics, kinetics, and muscle activity during wheelchair propulsion is compensatory or evolutionary by tracking individuals longitudinally.

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Copyright © 2009 by American Society of Mechanical Engineers
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Figures

Grahic Jump Location
Figure 1

Participant setup. Subject outfitted with reflective markers and surface electrodes on the upper arm, with SmartWheel’s attached to the subject’s wheelchair, for kinematics, EMG, and kinetics data collection, respectively. Wheelchair is mounted on a dynamometer and secured down for safety. The coordinate system of the SmartWheel’s is drawn on the setup.

Grahic Jump Location
Figure 3

Comparing peak muscle firing in relation to maximal voluntary contraction between groups. Mean (±SEM) peak muscle amplitude in relation to maximal voluntary contraction for the anterior and posterior deltoid, biceps, and triceps.

Grahic Jump Location
Figure 4

Comparing triceps burst duration and peak firing throughout propulsion. Muscle activity normalized to propulsion with peak muscle activity denoted by the triangles on the graph. Contrary to able-bodied participants, persons with paraplegia have a longer burst duration, with activity early on in the propulsion cycle.

Grahic Jump Location
Figure 2

Participant contact and release angles. Contact (top diagram) and release (bottom diagram) angles for able-bodied and persons with paraplegia. Anterior axle positioning (relative to the shoulder) was obtained from Vicon. Anthropometrics data—upper and lower arm lengths—were collected as part of the testing protocol. Most mechanically efficient (left) to least mechanically efficient (right), based on initial positioning. Figures drawn to scale. Two-dimensional motion assumed.

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