Effects of Daily Physical Activity Level on Manual Wheelchair Propulsion Technique in Full-Time Manual Wheelchair Users during Steady State Treadmill Propulsion

Publication date: Available online 2 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jennifer Dysterheft, Ian Rice, Yvonne Learmonth, Dominque Kinnett-Hopkins, Robert Motl
ObjectiveTo examine whether differences in propulsion technique as a function of intra-individual variability occur as a result of shoulder pain and physical activity (PA) level in full time manual wheelchair users (MWU).DesignObservational study.SettingResearch laboratory.ParticipantsA sample of 14 MWU completed the study. Participants were 18-64 years old, used a wheelchair for > 80% ambulation, and free of any condition that could be worsened by PA.InterventionsN/AMain Outcome MeasuresPA level was measured using the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and shoulder pain was measured using the Wheelchair Users Shoulder Pain Index survey (WUSPI). Mean and intra-individual variability propulsion metrics were measured for propulsion analysis.ResultsWUSPI scores indicated participants experienced low levels of shoulder pain. Results of the Spearman's rank-order correlation revealed PASIPD scores were significantly related to mean Contact Angle (rs=-0.57) and Stroke Frequency (rs=0.60), and coefficient of variability (CV) of Peak Force (rs=0.63), Peak Torque (rs= 0.59), Contact Angle (rs= 0.73), and Stroke Frequency (rs=0.60). WUSPI scores were significantly correlated to only mean Peak Force (p=0.02). No significant correlations were observed between PASIPD, WUSPI, and body mass index (BMI) scores.ConclusionsDifferences in propulsion technique were observed based on PA levels. Participants with higher PASIPD scores used a more injurious stroke technique when propelling at faster speeds. This may indicate active individuals who use injurious stroke, may be at higher risk of injury. A strong relationship was found between peak propulsion forces and shoulder pain. Rehabilitation professionals should emphasize the use of a protective stroke technique in both inactive and active MWU during exercise and faster propulsion.



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