Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 1 , Pages 20-26 , January 2009

Redefining the Manual Wheelchair Stroke Cycle: Identification and Impact of Nonpropulsive Pushrim Contact

Presented to the Rehabilitation Engineering and Assistive Technology Society of North America, June 15–19, 2007, Phoenix, AZ.

  • Andrew M. Kwarciak, MS

      Affiliations

    • Kessler Medical Rehabilitation Research and Education Center, West Orange, NJ
    • Corresponding Author InformationReprint requests to Andrew M. Kwarciak, MS, Kessler Medical Rehabilitation Research and Education Center, 1199 Pleasant Valley Way, West Orange, NJ 07052
    • ,
  • Sue Ann Sisto, PT, PhD

      Affiliations

    • Kessler Medical Rehabilitation Research and Education Center, West Orange, NJ
    • Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ
    • Department of Rehabilitation Science, Stony Brook University, Stony Brook, NY
    • ,
  • Mathew Yarossi, BS

      Affiliations

    • Kessler Medical Rehabilitation Research and Education Center, West Orange, NJ
    • ,
  • Robert Price, MSME

      Affiliations

    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA
    • ,
  • Eugene Komaroff, PhD

      Affiliations

    • Kessler Medical Rehabilitation Research and Education Center, West Orange, NJ
    • Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ
    • ,
  • Michael L. Boninger, MD

      Affiliations

    • Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA
    • Departments of Bioengineering and Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
    • Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center Health System, Pittsburgh, PA

  • Image Result

    Four classic stroke patterns (clockwise from upper left): arcing, DLOP, semi-circular, and SLOP. The arcing and SLOP patterns were classified as over-rim propulsive strokes while the semi-circular and

    Four classic stroke patterns (clockwise from upper left): arcing, DLOP, semi-circular, and SLOP. The arcing and SLOP patterns were classified as over-rim propulsive strokes while the semi-circular and DLOP patterns were classified as under-rim propulsive strokes. Abbreviations: DLOP, double-looping over propulsion; SLOP, single-looping over propulsion.

  • Image Result
    Proposed subdivision of pushrim contact. The contact phase begins when Ftot exceeds its threshold and ends when Ftot drops back below its threshold. The generation of a propulsive moment divides the c

    Proposed subdivision of pushrim contact. The contact phase begins when Ftot exceeds its threshold and ends when Ftot drops back below its threshold. The generation of a propulsive moment divides the contact phase into the initial contact, propulsion, and release periods. The recovery phase constitutes the remainder of the stroke cycle, when no Ftot is detected. Abbreviations: Ftot, total force on the pushrim; Max, axle moment.

  • Image Result
    The new definition of the stroke cycle. The stroke is divided into the contact phase and the recovery phase; and the contact phase is subdivided into the initial contact, propulsion, and release perio

    The new definition of the stroke cycle. The stroke is divided into the contact phase and the recovery phase; and the contact phase is subdivided into the initial contact, propulsion, and release periods. An indication of potential recovery periods is made as future research may lead to a subdivision of the recovery phase. Adapted from Perry15 and Sutherland et al.33

 Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133A011107) and by the Henry H. Kessler Foundation.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

PII: S0003-9993(08)01546-3

doi: 10.1016/j.apmr.2008.07.013

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 1 , Pages 20-26 , January 2009

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