Manual Wheelchair Propulsion Training
|Manual Wheelchair Users||Procedure: Instruction Only Procedure: Instruction and Feedback|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Basic Science
|Official Title:||Manual Wheelchair Propulsion Training|
- 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) ]
- Stroke pattern [ Time Frame: initial visit, visit 2 (1 week later), visit 3 (2 weeks later), and visit 4 (3 months from initial visit). ]
|Study Start Date:||December 2003|
|Study Completion Date:||November 2012|
|Primary Completion Date:||March 2008 (Final data collection date for primary outcome measure)|
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.
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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00226252
|United States, Pennsylvania|
|Human Engineering Research Laboratories|
|Pittsburgh, Pennsylvania, United States, 15206|
|Principal Investigator:||Michael L Boninger, MD||University of Pittsburgh and VA Pittsburgh Healthcare System|