Kinetic analysis of manual wheelchair propulsion under different environmental conditions between experienced and new manual wheelchair users with spinal cord injury

Abstract

Objectives: To compare wheelchair propulsion kinetics between new (acute) and experienced (chronic) manual wheelchair users with spinal cord injury (SCI) under natural environmental conditions and secondly; to examine the association between shoulder pain and propulsion kinetic outcomes. Methods: Thirteen participants per group participated. Propulsion kinetic parameters were measured using the Smartwheel. Shoulder pain was assessed using Wheelchair Users Shoulder Pain index. A factorial ANOVA was used to determine interaction and main effects of group (acute, chronic) and condition (tile, carpet and ramp). Results: Participants in both groups were matched for level of injury. There was no significant difference between groups for propulsion kinetics including peak force, push frequency, push length and speed. Push mechanical effectiveness was significantly higher in the acute group. Shoulder pain was significantly associated with propulsion kinetic outcomes in the acute group. Conclusion: Our findings suggest individual attention to propulsion kinetics during propulsion training under acute rehabilitation and follow-up programs designed to refine propulsion strategies for people with chronic SCI living in the community.