Comparison of muscular activity and metabolic response between a novel handle-based and a push-rim wheelchair in a simulated daily mobility circuit
DOI:
https://doi.org/10.2340/jrm.v58.44397Keywords:
wheelchair, electromyography, spirometry, activities of daily livingAbstract
Objective: To compare the muscular activity and metabolic response between a novel handle-based wheelchair drive (KURT) and conventional push rim propulsion in a simulated daily mobility circuit.
Design: Single-group comparative study between 3 wheelchair configurations.
Participants: 22 healthy individuals without prior wheelchair experience.
Methods: Participants completed a multi--movement circuit including ramps, obstacle avoidance, and directional changes using KURT and 2 push-rim wheelchairs with different wheel sizes (small wheels, SW; large wheels, LW). Electromyographic data were collected bilaterally from 7 upper body muscles, and cardiopulmonary variables were -continuously monitored.
Results: Biceps brachii activity was significantly higher with KURT than with SW and LW for both arms (all p < 0.001), while triceps brachii and pectoralis major activity were significantly lower (all p < 0.001). Other monitored muscles showed smaller relative differences between configurations, often resulting in limited or no statistically significant effects. Metabolic demand was lower with KURT: heart rate, oxygen consumption, and carbon dioxide production were reduced compared with LW (all p < 0.05), while respiratory exchange ratio was unchanged and respiratory frequency was higher than with SW (p < 0.05).
Conclusion: KURT appears to be a promising, more energy-efficient alternative to push-rim wheelchairs, reducing upper limb muscle demand and metabolic cost. These findings motivate studies in regular wheelchair users and longer-term use in daily living scenarios.
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Wessels KK, Brown JL, Ebersole KT, Sosnoff JJ. Sex, shoulder pain, and range of motion in manual wheelchair users. J Rehabil Res Dev 2013; 50: 351–356.
https://doi.org/10.1682/jrrd.2011.02.0025 DOI: https://doi.org/10.1682/JRRD.2011.02.0025
Sonenblum SE, Sprigle S, Lopez RA. Manual wheelchair use: bouts of mobility in everyday life. Rehabil Res Pract 2012; 2012: 753165.
https://doi.org/10.1155/2012/753165 DOI: https://doi.org/10.1155/2012/753165
Koontz AM, Cooper RA, Boninger ML, Yang Y, Impink BG, van der Woude LHV. A kinetic analysis of manual wheelchair propulsion during start-up on select indoor and outdoor surfaces. J Rehabil Res Dev 2005; 42: 447–458.
https://doi.org/10.1682/jrrd.2004.08.0106 DOI: https://doi.org/10.1682/JRRD.2004.08.0106
Liampas A, Neophytou P, Sokratous M, Varrassi G, Ioannou C, Hadjigeorgiou GM, et al. Musculoskeletal pain due to wheelchair use: a systematic review and meta-analysis. Pain Ther 2021; 10: 973–984.
https://doi.org/10.1007/s40122-021-00294-5 DOI: https://doi.org/10.1007/s40122-021-00294-5
Domingues I, Pinheiro J, Silveira J, Francisco P, Jutai J, Correia Martins A. Psychosocial impact of powered wheelchair, users’ satisfaction and their relation to social participation. Technologies 2019; 7: 73.
https://doi.org/10.3390/technologies7040073 DOI: https://doi.org/10.3390/technologies7040073
Dallmeijer AJ, Zentgraaff IDB, Zijp NI, van der Woude LHV. Submaximal physical strain and peak performance in handcycling versus handrim wheelchair propulsion. Spinal Cord 2004; 42: 91–98.
https://doi.org/10.1038/sj.sc.3101566 DOI: https://doi.org/10.1038/sj.sc.3101566
Puchinger M. Development of a novel handle-based wheelchair propulsion device [PhD thesis]. Vienna: TU Wien; 2023.
https://doi.org/10.34726/hss.2023.20342
Babu Rajendra Kurup N, Puchinger M, Gföhler M. A preliminary muscle activity analysis: handle based and push-rim wheelchair propulsion. J Biomech 2019; 89: 119–122.
https://doi.org/10.1016/j.jbiomech.2019.04.011 DOI: https://doi.org/10.1016/j.jbiomech.2019.04.011
Babu Rajendra Kurup N, Puchinger M, Gföhler M. Forward dynamic optimization of handle path and muscle activity for handle based isokinetic wheelchair propulsion: a simulation study. Comput Methods Biomech Biomed Engin 2019; 22: 55–63.
https://doi.org/10.1080/10255842.2018.1527321 DOI: https://doi.org/10.1080/10255842.2018.1527321
Puchinger M, Kurup N, Gstaltner K, Pandy MG, Gföhler M. Metabolic cost and mechanical efficiency of a novel handle-based device for wheelchair propulsion. J Rehabil Med 2022; 54: jrm00346.
https://doi.org/10.2340/jrm.v54.1503 DOI: https://doi.org/10.2340/jrm.v54.1503
Stegeman DF, Hermens HJ. Standards for surface electromyography: the European project Surface EMG for non-invasive assessment of muscles (SENIAM). Enschede: Roessingh Research and Development; 2007.
Soltani P, Vilas-Boas JP. Muscle activation during exergame playing. In: Novák D, Tulu B, Brendryen H, editors. Handbook of research on holistic perspectives in gamification for clinical practice. Hershey PA: IGI Global; 2016. p. 312–333.
https://doi.org/10.4018/978-1-4666-9522-1.ch015 DOI: https://doi.org/10.4018/978-1-4666-9522-1.ch015
Król H, Sobota G, Nawrat A. Effect of electrode position on EMG recording in pectoralis major. J Hum Kinet 2007; 17: 105–112.
Perotto A. Anatomical guide for the electromyographer: the limbs and trunk. 4th ed. Springfield IL: Charles C Thomas; 2005.
Cavallone P, Vieira T, Quaglia G, Gazzoni M. Electromyographic activities of shoulder muscles during Handwheelchair.Q vs pushrim wheelchair propulsion. Med Eng Phys 2022; 106: 103833.
https://doi.org/10.1016/j.medengphy.2022.103833 DOI: https://doi.org/10.1016/j.medengphy.2022.103833
Rankin JW, Richter WM, Neptune RR. Individual muscle contributions to push and recovery subtasks during wheelchair propulsion. J Biomech 2011; 44: 1246–1252.
https://doi.org/10.1016/j.jbiomech.2011.02.073 DOI: https://doi.org/10.1016/j.jbiomech.2011.02.073
Chang YW, Hughes RE, Su FC, Itoi E, An KN. Prediction of muscle force involved in shoulder internal rotation. J Shoulder Elbow Surg 2000; 9: 188–195.
https://doi.org/10.1067/mse.2000.105135 DOI: https://doi.org/10.1067/mse.2000.105135
Ackland DC, Pak P, Richardson M, Pandy MG. Moment arms of the muscles crossing the anatomical shoulder. J Anat 2008; 213: 383–390.
https://doi.org/10.1111/j.1469-7580.2008.00965.x DOI: https://doi.org/10.1111/j.1469-7580.2008.00965.x
Boninger ML, Cooper RA, Shimada SD, Rudy TE. Shoulder and elbow motion during two speeds of wheelchair propulsion: a description using a local coordinate system. Spinal Cord 1998; 36: 418–426.
https://doi.org/10.1038/sj.sc.3100588 DOI: https://doi.org/10.1038/sj.sc.3100588
Sauret C, Bascou J, de Saint Rémy N, Pillet H, Vaslin P, Lavaste F. Assessment of field rolling resistance of manual wheelchairs. J Rehabil Res Dev 2012; 49: 63–74.
https://doi.org/10.1682/jrrd.2011.03.0050 DOI: https://doi.org/10.1682/JRRD.2011.03.0050
Bekker MJ, Vegter RJK, van der Scheer JW, Hartog J, de Groot S, de Vries W, et al. Scapular kinematics during manual wheelchair propulsion in able-bodied participants. Clin Biomech 2018; 54: 54–61.
https://doi.org/10.1016/j.clinbiomech.2018.03.008 DOI: https://doi.org/10.1016/j.clinbiomech.2018.03.008
Kloosterman MG, Buurke JH, de Vries W, van der Woude LHV, Rietman JS. Effect of power-assisted hand-rim wheelchair propulsion on shoulder load in experienced wheelchair users: a pilot study with an instrumented wheelchair. Med Eng Phys 2015; 37: 961–968.
https://doi.org/10.1016/j.medengphy.2015.07.004 DOI: https://doi.org/10.1016/j.medengphy.2015.07.004
Camargo PR, Neumann DA. Kinesiologic considerations for targeting activation of scapulothoracic muscles – part 2: trapezius. Braz J Phys Ther 2019; 23: 467–475.
https://doi.org/10.1016/j.bjpt.2019.01.011 DOI: https://doi.org/10.1016/j.bjpt.2019.01.011
Mason BS, Vegter RJK, Paulson TAW, Morrissey D, van der Scheer JW, Goosey-Tolfrey VL. Bilateral scapular kinematics, asymmetries and shoulder pain in wheelchair athletes. Gait Posture 2018; 65: 151–156.
https://doi.org/10.1016/j.gaitpost.2018.07.170 DOI: https://doi.org/10.1016/j.gaitpost.2018.07.170
Chow JW, Millikan TA, Carlton LG, Chae WS, Lim YT, Morse MI. Kinematic and electromyographic analysis of wheelchair propulsion on ramps of different slopes for young men with paraplegia. Arch Phys Med Rehabil 2009; 90: 271–278.
https://doi.org/10.1016/j.apmr.2008.07.019 DOI: https://doi.org/10.1016/j.apmr.2008.07.019
Gauthier C, Grangeon M, Ananos L, Brosseau R, Gagnon DH. Quantifying cardiorespiratory responses resulting from speed and slope increments during motorized treadmill propulsion among manual wheelchair users. Ann Phys -Rehabil Med 2017; 60: 281–288.
https://doi.org/10.1016/j.rehab.2017.02.007 DOI: https://doi.org/10.1016/j.rehab.2017.02.007
Amazeen PG, Amazeen EL, Beek PJ. Coupling of breathing and movement during manual wheelchair propulsion. J Exp Psychol Hum Percept Perform 2001; 27: 1243–1259. DOI: https://doi.org/10.1037//0096-1523.27.5.1243
https://doi.org/10.1037/0096-1523.27.5.1243 DOI: https://doi.org/10.1037/0096-1523.27.5.1243
Reid M, Lawrie A, Hunter J, Warren P. The effect of steering on the physiological energy cost of wheelchair propulsion. Scand J Rehabil Med 1990; 22: 139–143. DOI: https://doi.org/10.2340/165019991990139143
Sawka MN, Glaser RM, Wilde SW, von Luhrte TC. Metabolic and circulatory responses to wheelchair and arm crank exercise. J Appl Physiol 1980; 49: 784–788.
https://doi.org/10.1152/jappl.1980.49.5.784 DOI: https://doi.org/10.1152/jappl.1980.49.5.784
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