Manual Wheelchair Propulsion Training

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00226252
Recruitment Status : Completed
First Posted : September 26, 2005
Last Update Posted : March 12, 2013
University of Pittsburgh
Information provided by (Responsible Party):
Michael Boninger, University of Pittsburgh

Brief Summary:
The purpose of this research study is to investigate a manual wheelchair training program to improve the way manual wheelchair users push their wheelchairs.

Condition or disease Intervention/treatment Phase
Manual Wheelchair Users Procedure: Instruction Only Procedure: Instruction and Feedback Not Applicable

Detailed Description:

The purpose of this research is to create a manual wheelchair propulsion-training program (MWPTP) that emphasizes propulsion techniques that improve the manual wheelchair users stroke pattern and efficiency. It is our hope that the design of a manual wheelchair-training program can help to minimize the upper extremity pain and injury often associated with manual wheelchair propulsion.

The MWPTP will exist in three forms, and will be given to three randomly assigned groups of subjects. An instruction only group (IO) will receive general instructions on how to best propel their wheelchair. A feedback group (FB) will receive additional instruction in wheelchair propulsion using a monitor displaying a random combination and amount of biomechanical feedback variables, such as cadence and proportion of time spent in propulsion. Subjects will be coached to develop an appropriate propulsion style that minimizes all of the predetermined feedback measures, which indicate poor technique and maximize all of the graphical measures indicating good propulsion technique. A control group (CG) will receive only testing which will be identical to the testing procedures followed by the IO and FB groups.

Participation in this study will consist of four visits to the Human Engineering Research Lab (HERL) for the FB, IO and CG. Visits 1-4 will be the same, except visit 4 will not include training for any of the groups. All subjects will use their own wheelchair and cushion; however researchers will attach SMART Wheels TM to the subjects' wheelchair in place of their current wheels. The SMART Wheels TM are used to record the forces and moments that occur during propulsion and will not alter the dimensions or feel of the subjects current wheelchair. During each visit, all subjects will be asked to push over a real life course that includes various grades and surfaces. Then they will be asked to push on a wheelchair dynamometer at 1 meter/sec for one minute, 2 meter/sec for one minute, and a self selected speed for one minute. During this time, data will may also be collected with use of an Optotrak kinematic measurement system that incorporates a camera 3D-motion analysis system.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 28 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Basic Science
Official Title: Manual Wheelchair Propulsion Training
Study Start Date : December 2003
Actual Primary Completion Date : March 2008
Actual Study Completion Date : November 2012

Arm Intervention/treatment
Experimental: Instruction Only (IO)
IO participants will train on the dynamometer for the same length of time as the Feedback Group. They will only be instructed to follow what they learned from the video presented at the beginning of the training session.
Procedure: Instruction Only
Video details an individual propelling a manual wheelchair with biomechanically correct propulsion technique.
Experimental: Instruction and Feedback Group (FB)
The FB group will receive video training, and real time feedback from the SMART Wheel as they push their wheelchair. A monitor displaying a random combination and amount of biomechanical feedback variables will be placed in front of subjects. Subjects will be instructed to adjust their stroke to optimize their biomechanics with feedback from the screen.
Procedure: Instruction and Feedback
Individuals will watch video of correct propulsion technique and will receive real-time feedback from the SMART Wheel as they push their wheelchair to help optimize their propulsion technique.
No Intervention: Control Group
Wheelchair characteristics will be noted; however, no wheelchair manipulation or changes in equipment will be performed or recommended.

Primary Outcome Measures :
  1. Stroke frequency, peak forces, time spent in propulsion [ Time Frame: initial visit, visit 2 (1 week later), visit 3 (2 weeks later), visit 4 (3 months from initial visit) ]
  2. Stroke pattern [ Time Frame: initial visit, visit 2 (1 week later), visit 3 (2 weeks later), and visit 4 (3 months from initial visit). ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • 18 years of age or greater
  • Use of a manual wheelchair as primary means of mobility (>80% of their ambulation)
  • Spinal Cord Injury (SCI) cervical 7 level and lower

Exclusion Criteria:

  • Wheelchair athletes having competed in racing in the last year.
  • Current upper limb pain that limits mobility.
  • <1 year post inpatient rehabilitation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00226252

United States, Pennsylvania
Human Engineering Research Laboratories
Pittsburgh, Pennsylvania, United States, 15206
Sponsors and Collaborators
VA Pittsburgh Healthcare System
University of Pittsburgh
Principal Investigator: Michael L Boninger, MD University of Pittsburgh and VA Pittsburgh Healthcare System

Responsible Party: Michael Boninger, Chair, Department of Physical Medicine and Rehabilitation, University of Pittsburgh Identifier: NCT00226252     History of Changes
Other Study ID Numbers: 02159
First Posted: September 26, 2005    Key Record Dates
Last Update Posted: March 12, 2013
Last Verified: March 2013

Keywords provided by Michael Boninger, University of Pittsburgh: