Hartog, J. (Johanneke) (2014) The effect of a 16-week low-intensity wheelchair training on mechanical efficiency, propulsion technique and the shoulder-load of manual wheelchair users with a chronic spinal cord injury. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background: The high prevalence (31-71%) of shoulder pain in persons with spinal cord injury (SCI) limits the performance of daily life activities. Insights in the effects of training on shoulder load are necessary to develop goal directed protocols to prevent shoulder pain. This study evaluated the effects of a low-intensity aerobic wheelchair exercise program on mechanical efficiency (ME), propulsion technique and shoulder load in persons with a chronic SCI. Methods: A pre-post design was performed in 7 deconditioned persons with SCI, who followed a 16-week aerobic wheelchair training (30–40% HRR, 2x30 min/week). During a submaximal wheelchair exercise test on a motor-driven treadmill, respiratory gases were measured and kinetic and kinematic data collected. From these data ME, propulsion technique and shoulder load were determined before, during and after the training. Mean and peak glenohumeral contact forces (GH forces) were calculated using an inverse dynamic model (Delft Shoulder and Elbow model). Results: There was a significant reduction in propulsion frequency (from 50.3 to 38.3 push/min, P = 0.01), the negative work at the start of the push (from -2.1 to -1.2W, P = 0.02) and the energy expenditure (-19.8 %, P = 0.01). The reduction in energy expenditure did not lead to a change in ME. Both peak and mean GH forces indicate a borderline significant decrease after 8 weeks of respectively 172.6 and 52.2N (P = 0.06 & P = 0.09). The results after 16 weeks could not statistically be analyzed, since data of only three participants were available due to technical limitations, while two participants did not continue after 8 weeks. Conclusion: The indicated reduction in GH forces in combination with the decrease in propulsion frequency indicates a lower absolute strain during wheelchair propulsion after 8 weeks of low intensity training. This training may possibly reduce the risk of overuse complaints in the investigated population. Conclusions should be taken with caution, because of the small sample size and the current limited study design. To maintain feasibility, future research should also focus on able-bodied persons.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Scheer, J.W. van der and Vegter, R.J.K. and Veeger, H.E.J. and Woude, L.H.V. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 01 Apr 2022 11:48 |
| Last Modified: | 01 Apr 2022 11:51 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3017 |
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