Physiological and biomechanical comparison of overground, treadmill, and ergometer handrim wheelchair propulsion in able
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RESEARCH
Physiological and biomechanical comparison of overground, treadmill, and ergometer handrim wheelchair propulsion in able‑bodied subjects under standardized conditions Rick de Klerk1* , Vera Velhorst1, Dirkjan (H.E.J.) Veeger2, Lucas H. V. van der Woude1,3 and Riemer J. K. Vegter1
Abstract Background: Handrim wheelchair propulsion is often assessed in the laboratory on treadmills (TM) or ergometers (WE), under the assumption that they relate to regular overground (OG) propulsion. However, little is known about the agreement of data obtained from TM, WE, and OG propulsion under standardized conditions. The current study aimed to standardize velocity and power output among these three modalities to consequently compare obtained physiological and biomechanical outcome parameters. Methods: Seventeen able-bodied participants performed two submaximal practice sessions before taking part in a measurement session consisting of 3 × 4 min of submaximal wheelchair propulsion in each of the different modalities. Power output and speed for TM and WE propulsion were matched with OG propulsion, making them (mechanically) as equal as possible. Physiological data and propulsion kinetics were recorded with a spirometer and a 3D measurement wheel, respectively. Results: Agreement among conditions was moderate to good for most outcome variables. However, heart rate was significantly higher in OG propulsion than in the TM condition. Push time and contact angle were smaller and fraction of effective force was higher on the WE when compared to OG/TM propulsion. Participants used a larger cycle time and more negative work per cycle in the OG condition. A continuous analysis using statistical parametric mapping showed a lower torque profile in the start of the push phase for TM propulsion versus OG/WE propulsion. Total force was higher during the start of the push phase for the OG conditions when compared to TM/WE propulsion. Conclusions: Physiological and biomechanical outcomes in general are similar, but possible differences between modalities exist, even after controlling for power output using conventional techniques. Further efforts towards increasing the ecological validity of lab-based equipment is advised and the possible impact of these differences -if at all- in (clinical) practice should be evaluated. Keywords: Dynamometry, Biomechanics, Power output, Gross mechanical efficiency
*Correspondence: [email protected] 1 Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands Full list of author information is available at the end of the article
Background The repetitive and relatively high loads on the upperextremities during handrim wheelchair propulsion, associated with an increased risk of pain and pathology [1–3], are a continued concern addressed in wheelchair
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use,
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