Using a mobility assistance dog reduces upper limb effort during manual wheelchair ramp ascent in an individual with spinal cord injury

Abstract

Objective

To compare the mechanical and muscular efforts generated in the non-dominant upper limb (U/L) when ascending a ramp with and without the use of a mobility assistance dog (AD_Mob) in a manual wheelchair user with a spinal cord injury.

Method

The participant ascended a ramp at natural speed using his personal wheelchair with (three trials) and without (three trials) his AD_Mob. Movement parameters of the wheelchair, head, trunk, and non-dominant U/L (i.e. hand, forearm, and arm segments) were recorded with a motion analysis system. The orthogonal force components applied on the hand rims by the U/Ls were computed with instrumented wheels. Muscular activity data of the clavicular fibers of the pectoralis major, the anterior fibers of the deltoid, the long head of the biceps brachii, and the long head of the triceps brachii were collected at the non-dominant U/L.

Results

During uphill propulsion with the AD_Mob, the total and tangential forces applied at the non-dominant handrim, along with the rate of rise of force, were reduced while mechanical efficiency was improved compared to uphill propulsion without the AD_Mob. Similarly, the resultant net joint movements (wrist, elbow, and shoulder) and the relative muscular demands (biceps, triceps, anterior deltoid, pectoralis major) decreased during uphill propulsion with an AD_Mob versus without an AD_Mob.

Conclusion

Propelling uphill with the assistance of an AD_Mob reduces U/L efforts and improves efficiency compared to propelling uphill without its assistance in a manual wheelchair user with a spinal cord injury.

Keywords:

• (MeSH): Spinal cord injuries
• Paraplegia
• Assistance dog
• Rehabilitation
• Activities of daily living, Assistive technology, Task performance and analysis, Upper extremity, Wheelchair

Acknowledgments

The authors acknowledge Guillaume Desroches (postdoctoral fellow), Youssef El Khamlichi (research associate), and Philippe Gourdou (research associate) for their endless assistance during data collection, processing, and analysis. Special thanks are also extended to Prof. Michel Y. Tousignant and Prof. Lise Poissant for their intellectual contribution to the project. Dany Gagnon holds a Junior 1 Research Career Award from the Fonds de la recherche en santé du Québec (FRSQ) and is a member of the SensoriMotor Rehabilitation Research Team funded by the Canadian Institute of Health Research (CIHR). Marie Blanchet holds a Summer Undergraduate Student Research Award from the Institute of Musculoskeletal Health and Arthritis of the CIHR. The project was supported by the Traumatology Research Consortium of the Fonds de la recherche en santé du Québec (FRSQ). The equipment and material required for the research conducted at the Pathokinesiology Laboratory was financed, in part, by the Canada Foundation for Innovation (CFI).