Document Detail

Hand rim configuration: effects on physical strain and technique in unimpaired subjects?
MedLine Citation:
PMID:  14519349     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Hand rim wheelchair propulsion is inefficient and physically straining. To evaluate the possibly advantageous role in this respect of three different prototype hand rim configurations (a rubber foam-coated cylindrical (II) hand rim and two profiled rubber foam-coated hand rims (wide and narrow: III, IV)), a group of 10 unimpaired subjects conducted four submaximal discontinuous wheelchair exercise tests on a computer-controlled wheelchair ergometer, thus allowing a comparison with a standard hand rim (chromium-plated round hand rim (I)). METHODS: Apart from physiological measures (oxygen uptake, heart rate (HR), ventilation, mechanical efficiency (ME)), a subjective score for the rating of each of the hand rims was determined, as well as characteristics of the force application in the propulsion phase during each test condition. Timing parameters of the push and recovery phase were determined. Each exercise test was conducted with one of the four hand rim configurations in a counter-balanced order. RESULTS: Analysis of variance with repeated measures (hand rim configuration, power output) revealed no significant effects (P>0.05) on any of the physiological parameters and force application characteristics for the main factor 'hand rim configuration'. Only the subjective score (scale 0-10) for rating of the hand rims proved significantly different between the round rubber (7.5+/-0.53) coated hand rim-receiving the highest score-versus the narrow rubber-coated flat profiled hand rim (5.5+/-1.72). DISCUSSION: In this subject group and under the selected tasks and submaximal conditions of wheelchair propulsion, the studied hand rim configurations did not introduce critical shifts in the technique of (de-)coupling and power production in the push phase. As a consequence, no systematic shifts in ME are found among the different hand rim configurations. It is suggested that the biological constraints of the task overrule the possible effects of small design variations of the different hand rim configurations within the studied subject group and under the limited test conditions. The hand rim design characteristics may however be much more critical in (1) experienced wheelchair users, (2) especially those subjects with a limited hand-arm and/or trunk function and/or (3) under much more extreme conditions of daily wheelchair ambulation (i.e. turning, stopping/starting, negotiating a slope) or during peak performance. These issues clearly require continued future research. As such, the current results can be viewed as preliminary results only.
L H V van der Woude; M Formanoy; S de Groot
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  Medical engineering & physics     Volume:  25     ISSN:  1350-4533     ISO Abbreviation:  Med Eng Phys     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-10-01     Completed Date:  2004-06-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9422753     Medline TA:  Med Eng Phys     Country:  England    
Other Details:
Languages:  eng     Pagination:  765-74     Citation Subset:  IM    
Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands.
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MeSH Terms
Energy Transfer / physiology*
Equipment Design
Equipment Failure Analysis*
Exercise Test
Hand / physiology*
Human Engineering / methods
Movement / physiology*
Oxygen Consumption / physiology*
Patient Satisfaction
Physical Exertion / physiology*
Stress, Mechanical
Task Performance and Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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