Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2018

Open Access 01-12-2018 | Research

Practice-based skill acquisition of pushrim-activated power-assisted wheelchair propulsion versus regular handrim propulsion in novices

Authors: Rick de Klerk, Thijs Lutjeboer, Riemer J. K. Vegter, Lucas H. V. van der Woude

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2018

Login to get access

Abstract

Background

Regular handrim wheelchair (RHW) propulsion is straining for the upper extremities and wheelchair users often experience overuse problems. A recent advancement in wheelchair technology that could assist users is the pushrim-activated power-assisted wheelchair (PAPAW). PAPAWs are challenging to control, yet it is unclear how people learn to use a PAPAW. The purpose of this study is to examine early skill acquisition through practice in PAPAWs and compare it with RHWs.

Methods

Twenty-four able-bodied novices were randomly allocated to either the RHW group or the PAPAW group. The experiment consisted of five sessions with three blocks of 4 min steady-state practice at 1.11 m/s and 0.21 W/kg. Finally, a transfer to the other mode was made. Data were collected with a drag-test, breath-by-breath spirometry, and a motion capture system. The last minute of each four-minute block was used for analysis. A mixed analysis of variance (ANOVA) was used to test for group, time, and interaction effects.

Results

Both groups improved their (assisted) mechanical efficiency, reduced their stroke rate, right-left and forward-backward deviation on the treadmill, and had a lower rate of perceived exertion (RPE) over time. (Assisted) mechanical efficiency was higher for the PAPAW group than for the RHW group and RPE was lower. However, left-right and forward-backward deviation was also found to be higher in the PAPAW group.

Conclusions

At the group level the energetic cost of RHW and PAPAW propulsion can be lowered through low-intensity practice in novice users. The PAPAW is more ‘efficient’ than the RHW given the reduced energy requirement of the user from the motor assist, but more difficult to control. Future studies on PAPAWs should focus on the control needs of the user and their interaction with the power-assist technology.
Literature
1.
2.
3.
Rauch A, Hinrichs T, Oberhauser C, Cieza A, SwiSCI Study Group. Do people with spinal cord injury meet the WHO recommendations on physical activity. Int J Public Health. 2016;61(1):17–27.
4.
van Drongelen S, De Groot S, Veeger H, Angenot E, Dallmeijer A, Post M, et al. Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury. Spinal Cord. 2006;44(3):152–9.CrossRefPubMed
5.
Dalyan M, Cardenas DD, Gerard B. Upper extremity pain after spinal cord injury. Spinal Cord. 1999;37(3):191–5.CrossRefPubMed
6.
Cooper RA, Boninger ML, Spaeth DM, Ding D, Guo S, Koontz AM et al. Engineering better wheelchairs to enhance community participation. IEEE Trans Neural Syst Rehabil Eng. 2006;14(4):438–55.
7.
8.
9.
van der Woude LH, Veeger HE, Dallmeijer AJ, Janssen TW, Rozendaal LA. Biomechanics and physiology in active manual wheelchair propulsion. Med Eng Phys. 2001;23(10):713–33. S135045330100083​2.CrossRefPubMed
10.
11.
Levy CE, Chow JW, Tillman MD, Hanson C, Donohue T, Mann WC. Variable-ratio pushrim-activated power-assist wheelchair eases wheeling over a variety of terrains for elders. Arch Phys Med Rehabil. 2004;85(1):104–12.CrossRefPubMed
12.
Algood SD, Cooper RA, Fitzgerald SG, Cooper R, Boninger ML. Effect of a pushrim-activated power-assist wheelchair on the functional capabilities of persons with tetraplegia. Arch Phys Med Rehabil. 2005;86(3):380–6. S000399930401157​8.CrossRefPubMed
13.
Algood SD, Cooper RA, Fitzgerald SG, Cooper R, Boninger ML. Impact of a pushrim-activated power-assisted wheelchair on the metabolic demands, stroke frequency, and range of motion among subjects with tetraplegia. Arch Phys Med Rehabil. 2004;85(11):1865–71. S000399930400655​0.CrossRefPubMed
14.
Lighthall-Haubert L, Requejo PS, Mulroy SJ, Newsam CJ, Bontrager E, Gronley JK, et al. Comparison of shoulder muscle electromyographic activity during standard manual wheelchair and push-rim activated power assisted wheelchair propulsion in persons with complete tetraplegia. Arch Phys Med Rehabil. 2009;90(11):1904–15. https://​doi.​org/​10.​1016/​j.​apmr.​2009.​05.​023.CrossRefPubMed
15.
16.
Arva J, Fitzgerald SG, Cooper RA, Boninger ML. Mechanical efficiency and user power requirement with a pushrim activated power assisted wheelchair. Med Eng Phys. 2001;23(10):699–705. S135045330100054​6.CrossRefPubMed
17.
Kloosterman MG, Eising H, Schaake L, Buurke JH, Rietman JS. Comparison of shoulder load during power-assisted and purely hand-rim wheelchair propulsion. Clin Biomech. 2012;27(5):428–35.CrossRef
18.
19.
20.
21.
22.
Elliott D, Hansen S, Mendoza J, Tremblay L. Learning to optimize speed, accuracy, and energy expenditure: a framework for understanding speed-accuracy relations in goal-directed aiming. J Mot Behav. 2004;36(3):339–51.CrossRefPubMed
23.
24.
Lay B, Sparrow W, Hughes K, O’Dwyer N. Practice effects on coordination and control, metabolic energy expenditure, and muscle activation. Hum Mov Sci. 2002;21(5):807–30.
25.
de Groot S, Veeger HEJ, Hollander AP, van der Woude LHV. Influence of task complexity on mechanical efficiency and propulsion technique during learning of hand rim wheelchair propulsion. Med Eng Phys. 2005;27(1):41–49.
26.
Van der Woude L, van Krmen E, Ariens G, Rozendal R, Veeger H. Physical strain and mechanical efficiency in hubcrank and handrim wheelchair propulsion. J Med Eng Technol. 1995;19(4):123–31.CrossRefPubMed
27.
Vegter RJ, Lamoth CJ, de Groot S, Veeger DH, van der Woude, Lucas HV. Inter-individual differences in the initial 80 minutes of motor learning of handrim wheelchair propulsion. PLoS One. 2014;9(2):e89729.
28.
Bays PM, Wolpert DM. Computational principles of sensorimotor control that minimize uncertainty and variability. J Physiol Lond. 2007;578(2):387–96.CrossRefPubMed
29.
van Ingen Schenau GJ. Some fundamental aspects of the biomechanics of overground versus treadmill locomotion. Med Sci Sports Exerc. 1980;12(4):257–61.CrossRefPubMed
30.
Baldwin TT, Ford JK. Transfer of training: a review and directions for future research. Pers Psychol. 1988;41(1):63–105.CrossRef
31.
Veeger D, Van der Woude L, Rozendal RH. The effect of rear wheel camber in manual wheelchair propulsion. J Rehabil Res Dev. 1989;26(2):37–46.PubMed
32.
Garby L, Astrup A. The relationship between the respiratory quotient and the energy equivalent of oxygen during simultaneous glucose and lipid oxidation and lipogenesis. Acta Physiol Scand. 1987;129(3):443–4.CrossRefPubMed
33.
34.
Pavlidou E, Kloosterman MG, Buurke JH, Rietman JS, Janssen TW. Rolling resistance and propulsion efficiency of manual and power-assisted wheelchairs. Med Eng Phys. 2015;37(11):1105–10.CrossRefPubMed
35.
Leving MT, Vegter RJ, Hartog J, Lamoth CJ, de Groot S, van der Woude, Lucas HV. Effects of Visual Feedback-Induced Variability on Motor Learning of Handrim Wheelchair Propulsion. PLoS One. 2015;10(5):e0127311.
36.
37.
Best KL, Kirby RL, Smith C, MacLeod DA. Comparison between performance with a pushrim-activated power-assisted wheelchair and a manual wheelchair on the wheelchair skills test. Disabil Rehabil. 2006;28(4):213–20. H16311V335658549​.CrossRefPubMed
38.
Vegter RJ, Hartog J, de Groot S, Lamoth CJ, Bekker MJ, van der Scheer, Jan W et al. Early motor learning changes in upper-limb dynamics and shoulder complex loading during handrim wheelchair propulsion. J Neuroeng Rehabil. 2015;12(1):1.
39.
Sparrow W, Irizarry-Lopez V. Mechanical efficiency and metabolic cost as measures of learning a novel gross motor task. J Mot Behav. 1987;19(2):240–64.CrossRefPubMed
40.
Issurin VB. Training transfer: scientific background and insights for practical application. Sports Med. 2013;43(8):675–94.
Metadata
Title
Practice-based skill acquisition of pushrim-activated power-assisted wheelchair propulsion versus regular handrim propulsion in novices
Authors
Rick de Klerk
Thijs Lutjeboer
Riemer J. K. Vegter
Lucas H. V. van der Woude
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2018
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-018-0397-4

Other articles of this Issue 1/2018

Journal of NeuroEngineering and Rehabilitation 1/2018 Go to the issue

Short report

Validating attentive locomotion training using interactive treadmill: an fNIRS study

Research

Assisting hand function after spinal cord injury with a fabric-based soft robotic glove

Research

Muscle fatigue assessment during robot-mediated movements

Research

Generalizing remotely supervised transcranial direct current stimulation (tDCS): feasibility and benefit in Parkinson’s disease

Research

Walking and balance outcomes for stroke survivors: a randomized clinical trial comparing body-weight-supported treadmill training with versus without challenging mobility skills

Research

Recovery of kinematic arm function in well-performing people with subacute stroke: a longitudinal cohort study