Jaspers, E.G. (Ewout) (2014) Learning with a lever-propelled wheelchair: the effect of three weeks of practice on efficiency and technique. thesis, Human Movement Sciences.
Full text available on request.Abstract
Introduction Lever-propelled wheelchairs are alternatives to hand-rim propelled wheelchairs that could decrease or prevent overuse injuries. An example of lever-propulsion is the NuDrive lever system. An attach-unit system that enables an upright posture and a continuous grip, potentially beneficial in preventing back problems and users with a limited hand function. These advantages make the NuDrive an interesting option for rehabilitation. Using the NuDrive is suggested to require a process of adaptation, i.e. motor learning. Knowledge about the effects of learning on efficiency and technique is necessary for the implementation in rehabilitation and could help prevent injuries. Methods Inexperienced able-bodied male participants were randomly divided over an experimental (n=8) and a control group (n=8). Pre- and post-test were three weeks apart and consisted of three exercise intervals of 4 minutes submaximal steady state exercise (0.30 W/kg, 1.11 m/s) in a wheelchair equipped with the NuDrive lever mechanism on a motorized treadmill. Exercise intervals were separated by 2 minutes of rest. The experimental group performed seven natural learning practice trials spread over the three weeks. Practice trials consisted of two 4 minute exercise intervals, with 2 minutes of rest in between, at the same exercise intensity. We measured gross mechanical efficiency and physical strain. Changes in technique were measured using: stroke frequency, push time, cycle time, percentage push time/cycle time and their coefficients of variation, hand-speed, hand-height, elbow angle, lever-angle and lever range of motion(ROM), as well as muscle activity in terms of muscle synergies (surface EMG; NNMF). Results An increasing trend was found for gross mechanical efficiency in the experimental group after three weeks of practice (interaction: p=0.098). Four participants had to be excluded from the gross mechanical efficiency and cardiorespiratory analysis. Push time, lever ROM and maximal hand-speed during the push phase increased significantly more in the experimental group. Average hand-speed during push phase showed a similar trend to maximal (interaction: p=0.070). Except for a trend on stroke frequency all CV variables decreased significantly more in 3 the experimental group. Three muscle synergies could be identified with the EMG analysis in NuDrive lever propulsion. Conclusion We found a trend indicating that gross mechanical efficiency increased more in the experimental group compared to the control group. Besides this trend we found a shift to longer-slower movement pattern and decreases in inter-cycle variability. These changes occurred primarily in the push phase. A more spread practice period seemed to benefit the inter-cycle variability. Small numbers undermined the statistical power of this experiment.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Woude, L.H.V. van der and Hettinga, F.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 01 Apr 2022 12:51 |
| Last Modified: | 01 Apr 2022 12:52 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3025 |
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