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The Influence of Wheelchair Propulsion Hand Pattern on Upper Extremity Muscle Power and Stress

机译:轮椅推进手型对上肢肌肉力量和压力的影响

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摘要

The hand pattern (i.e., full-cycle hand path) used during manual wheelchair propulsion is frequently classified as one of four distinct hand pattern types: arc, single loop, double loop and semicircular. Current clinical guidelines recommend the use of the semicircular pattern, which is based on advantageous levels of broad biomechanical metrics implicitly related to the demand placed on the upper extremity (e.g., lower cadence). However, an understanding of the influence of hand pattern on specific measures of upper extremity muscle demand (e.g., muscle power and stress) is needed to help make such recommendations, but these quantities are difficult and impractical to measure experimentally. The purpose of this study was to use musculoskeletal modeling and forward dynamics simulations to investigate the influence of the hand pattern used on specific measures of upper extremity muscle demand. The simulation results suggest that the double loop and semicircular patterns produce the most favorable levels of overall muscle stress and total muscle power. The double loop pattern had the lowest full-cycle and recovery-phase upper extremity demand but required high levels of muscle power during the relatively short contact phase. The semicircular pattern had the second-lowest full-cycle levels of overall muscle stress and total muscle power, and demand was more evenly distributed between the contact and recovery phases. These results suggest that in order to decrease upper extremity demand, manual wheelchair users should use either the double loop or semicircular pattern when propelling their wheelchairs at a self-selected speed on level ground.
机译:手动轮椅推进过程中使用的手形(即,全周期手形路径)经常被分类为四种不同的手形类型之一:弧形,单圈,双圈和半圆形。当前的临床指南推荐使用半圆形模式,其基于与上肢需求(例如,下脚踏圈速)隐式相关的广泛生物力学指标的有利水平。然而,需要了解手部姿势对上肢肌肉需求的特定量度(例如,肌肉力量和压力)的影响以帮助提出这样的建议,但是这些量是困难的并且在实验上无法测量。这项研究的目的是使用肌肉骨骼模型和正向动力学模拟来研究所用手型对上肢肌肉需求量度的影响。仿真结果表明,双环和半圆形模式产生了最有利的总体肌肉压力和总肌肉力量。双循环模式的全周期和恢复期上肢需求最低,但在相对短的接触阶段就需要高水平的肌肉力量。半圆形模式的整体肌肉压力和总肌肉力量的全循环水平第二低,并且需求在接触和恢复阶段之间更均匀地分布。这些结果表明,为了减少上肢的需求,手动轮椅使用者在水平地面上以自行选择的速度推进轮椅时,应使用双环或半圆形模式。

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