Arm strength and impulse generation: Initiation of wheelchair movement by the physically disabled

Abstract

The initiation of wheelchair movement is a function of starting technique, upper extremity strength and the stabilizing potential of the trunk musculature. This study examined the relation between arm strength, activity level, degree of disability and the maximum impulse generated from a resting position while seated in a wheelchair. Two starting techniques were examined using a force platform.

Sixteen male paraplegic adults (age 28·1 ±6·9 year, supine length l·62±0·16m, total body mass 61·2±16·2 kg) performed three grab starts and three strike starts on a Kistler force platform. For each technique, the processed data were averaged together and impulse in the forward/backward and vertical directions was determined. Isokinetic shoulder flexion and elbow extension moments of force were measured at an angular velocity of 60 degs⁻¹. Peak power and average power were calculated from digitized values of the moment of force-time curves.

Subjects were classified as highly active (HA, >2 exercise periods per week, N = 8) or less active (LA, N = 8). In addition, the site of spinal cord injury was quantified as a high level lesion (HL, above T10, N = 7) or low level lesion (LL, N = 9). There were no differences (p>0·05) between activity or lesion level groups with respect to age, height, total body mass or skinfold thicknesses. Nor were there significant differences between groups for shoulder and elbow power values. However, shoulder flexion scores for the combined groups were greater than those scores for elbow extension (peak power, 72·9 W versus 49·5 W; average power, 51·8 W versus 37·2 W). The grab start produced more forward impulse (the integral of forward force × time) (152·6 N s) than the strike start (119·5 N s, p < 0·05), but the magnitude of this difference was similar for the several groups. Wheelchair impulse scores were well correlated with strength values in both HA and LA subjects (r=0·74 to 0·89). However, the intercepts of the regression lines were dissimilar between activity groups, suggesting an interaction between activity pattern, muscle force and impulse.

Keywords:

• Biomechanics
• Wheelchair
• Disabled
• Impulse
• Arm strength.