A kinematic analysis of the wheelchair propulsion arm stroke of nonambulatory school age children
Hart, Timothy John
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The purpose of this study was threefold. First, and most important, was to investigate certain mechanical factors involved in the propulsion of standard rim drive wheelchairs by children. Second, the investigation sought to determine the potential changes in wheelchair stability during the course of the arm stroke movement. Finally, the relationships between selected anthropometric measures and the wheelchair selection criteria employed by the wheelchair manufacturers were examined, prompting a number of theoretical wheelchair design changes to be suggested by the investigator. The subjects were seven school age children who were required to use the standard rim drive wheelchair as their usual form of transportation during the school day. The subjects ranged in age from 6 to 12 years and all suffered from congenital diseases that did not affect the functioning of the musculature of the upper torso. The testing procedures included a number of anthropometric measures taken on each subject. A number of measures were also made on each subject's wheelchair. In addition, by the use of a standard reaction board technique, the location of the center of gravity of each wheelchair was determined. Each subject was then required to propel his/her wheelchair at normal transportation speed while a Milliken high-speed camera operating at approximately 100 frames per second recorded his/her movements. The cinematographic analysis procedure was undertaken using a Numonics Digitizer and an Apple 11+ mini-computer for data storage. Specially written computer programs were utilized to analyze the appropriate kinematic parameters. Upon completion of the study, the data were subjected to statistical analysis. Results indicated that the dominant hand of each subject did not significantly influence the arm stroke mechanics employed by the subjects. Analysis of the position of the subject's center of gravity during the arm stroke movement revealed that the wheelchair remained stable throughout the movement. The investigation determined through an analysis of the wheelchair selection criteria that both wheelchair seat width and seat back height were not in accordance with the manufacturer's suggested limits. Furthermore, very little emphasis was placed on the ability of the child to propel the wheelchair. The investigator concluded that an exacting wheelchair selection criteria and improved wheelchair fitting techniques were necessary in order that a more efficient wheelchair may be produced.