on biomechanical, ergonomic, and motor learning theory principles. ... While both training groups decreased stroke frequency (SF), the IO group ...... Although the number of studies linking propulsion mechanics of manual ..... the level of cervical 7 for fear of emphasizing biomechanics that were not practical or safe given.
Manual Wheelchair Propulsion Training By Ian Matthew Rice BA, University of Illinois 1999 MS, OT, Washington University 2002
Submitted to the Graduate Faculty of School of Health and Rehabilitation Sciences in partial fulfillment Of the requirements for the degree of PhD. in Rehabilitation Science and Technology
University of Pittsburgh
2010
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UNIVERSITY OF PITTSBURGH SCHOOL OF HEALTH AND REHABILITATION SCIENCES
This dissertation was presented
by
Ian Matthew Rice
It was defended on June 16th, 2010 and approved by
Rory Cooper, PhD, Rehabilitation Science and Technology, University of Pittsburgh Jere Gallagher, PhD, Associate Dean School of Education, University of Pittsburgh Lee Kirby, MD, Division of Physical Medicine and Rehabilitation, Dalhousie University Alicia Koontz, PhD, Rehabilitation Science and Technology, University of Pittsburgh Dissertation Advisor: Michael Boninger, MD, Department of Medicine, Physical Medicine and Rehabilitation, University of Pittsburgh
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Copyright © by Ian Rice, 2010
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Manual Wheelchair Propulsion Training Ian Matthew Rice, PhD University of Pittsburgh, 2010
Manual wheelchair users are at high risk of developing upper limb pain and injury. While much has been published identifying the prevalence of upper limb pain, very little has been published on its treatment and prevention. Consequently, a propulsion training system was developed based on biomechanical, ergonomic, and motor learning theory principles.
Three groups were
compared: a control group (CG) that received no training, an instruction only group (IO) that reviewed a multi media instructional presentation (MMP), and a feedback group (FB) that reviewed the MMP and received additional real time feedback (RTF). The purpose of this study was to 1) Develop propulsion-training programs that minimized injurious biomechanics; 2) Test if the training programs can cause lasting changes; 3) Investigate if resultant forces and moments at the shoulder can be reduced and 4) To determine if one treatment (MMP) was superior to the other (RTF) in achieving these goals. First, the RTF systems’ design was completed and tested on a pilot subject (chapter 2). Next the training systems were tested over ground (chapter 3) and on a dynamometer where shoulder forces were modeled (chapter 4) (N=27). Results showed baseline pain measures to be extremely low and did not increase significantly (p>.2). In addition, the effects of training were not influenced by surface type or speed condition (presence or absence of a target speed). In chapter 2, the FB group who received RTF and MMP displayed larger increases in contact angle(CA)(angle along the arc of the hand rim) and greater decreases in rate of rise of peak resultant force (rorFr) than the IO group who received the MMP alone (p
