Preliminary Outcomes of the SmartWheel Users’ Group Database: A Proposed Framework for Clinicians to Objectively Evaluate Manual Wheelchair Propulsion

Abstract 

Cowan RE, Boninger ML, Sawatzky BJ, Mazoyer BD, Cooper RA. Preliminary outcomes of the SmartWheel Users’ Group database: a proposed framework for clinicians to objectively evaluate manual wheelchair propulsion.

Objectives

To describe a standard clinical protocol for the objective assessment of manual wheelchair propulsion; to establish preliminary values for temporal and kinetic parameters derived from the protocol; and to develop graphical references and a proposed application process for use by clinicians.

Design

Case series.

Setting

Six research institutions that collect kinetic wheelchair propulsion data and contribute that data to an international data pool.

Participants

Subjects with spinal cord injury (N=128).

Interventions

Subjects propelled a wheelchair from a stationary position to a self-selected velocity across a hard tile surface, a low pile carpet, and up an Americans with Disabilities Act−compliant ramp. Unilateral kinetic data were obtained from subjects using a force and moment sensing pushrim.

Main Outcome Measures

Differences in self-selected velocity, peak resultant force, push frequency, and stroke length across all surfaces, relationship between (1) weight-normalized peak resultant force and self-selected velocity and (2) push frequency and self-selected velocity.

Results

Graphical references were generated for potential clinical use based on the relation between body weight−normalized peak resultant force, push frequency, and velocity. Self-selected velocity decreased (ramp < carpet < tile), peak resultant forces increased (ramp > carpet > tile), and push frequency and stroke length remained unchanged when compared across the different surfaces. Weight-normalized peak resultant force was a significant predictor of velocity on tile and ramp. Push frequency was a significant predictor of velocity on tile, carpet, and ramp.

Conclusions

We present preliminary data generated from a clinically practical manual wheelchair propulsion evaluation protocol and we describe a proposed method for clinicians to objectively evaluate manual wheelchair propulsion.

Key Words: Biomechanics, Engineering, Insurance, Rehabilitation, Wheelchairs