Journal articles: 'Wheelchair outcome measure'

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Mortenson, William B., William C. Miller, and Jan Miller-Pogar. "Measuring wheelchair intervention outcomes: Development of the Wheelchair Outcome Measure." Disability and Rehabilitation: Assistive Technology 2, no. 5 (January 2007): 275–85. http://dx.doi.org/10.1080/17483100701475863.

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Ouellet, Béatrice, Krista L. Best, Deb Wilson, and William C. Miller. "Exploring the Influence of a Community-Based Peer-Led Wheelchair Skills Training on Satisfaction with Participation in Children and Adolescents with Cerebral Palsy and Spina Bifida: A Pilot Study." International Journal of Environmental Research and Public Health 19, no. 19 (September 21, 2022): 11908. http://dx.doi.org/10.3390/ijerph191911908.

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Background: Peer-led approaches improve satisfaction with participation, wheelchair skills and wheelchair use self-efficacy in adults, but the evidence is limited in children. This pilot study aimed to explore the influence of community-based, peer-led, group wheelchair training program (i.e., Seating To Go) on satisfaction with participation (primary outcome), wheelchair skills, and wheelchair use self-efficacy in children and adolescents with cerebral palsy and spina bifida. Methods: A single group pre-post design was used. Invitations were shared online and diffused by clinicians and advocacy and provider groups to recruit a convenience sample of eight pediatric wheelchair users. Participants completed the Seating To Go program in groups that were facilitated by adult wheelchair users. Satisfaction with participation (Wheelchair Outcome Measure-Young People), wheelchair skills (Wheelchair Skills Test), wheelchair use self-efficacy (Wheelchair Use Confidence Scale), and perceived wheelchair skills capacity (Wheelchair Skills Test Questionnaire; proxy rating: parents) were evaluated before and after the Seating To Go program. Descriptive statistics and nonparametric longitudinal data analysis were conducted to explore changes in all outcomes from baseline to post-intervention. Results: Pediatric wheelchair users (ranging in age from 5 to 15 years) and their parents reported statistically significant improvements in satisfaction with participation. The improvements in wheelchair skills and wheelchair confidence were also statistically significant, but not the parents’ perception of their children’s wheelchair skills. Conclusions: A community-based peer-led approach to wheelchair skills training seems promising for improving wheelchair outcomes in pediatric wheelchair users. Further controlled studies with larger samples are warranted.

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Tuersley, Lorna, Nathan Bray, and Rhiannon Tudor Edwards. "Development of the Wheelchair outcomes Assessment Tool for Children (WATCh): A patient-centred outcome measure for young wheelchair users." PLOS ONE 13, no. 12 (December 26, 2018): e0209380. http://dx.doi.org/10.1371/journal.pone.0209380.

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Parvaneh, Shahriar, William B. Mortenson, and William C. Miller. "Validating the wheelchair outcome measure for residents in long-term care." Disability and Rehabilitation: Assistive Technology 9, no. 3 (April 23, 2013): 209–12. http://dx.doi.org/10.3109/17483107.2013.769126.

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Whitehouse, Christiane E., Janet Green, Sarah M. Giles, Rosanna Rahman, Jamesie Coolican, and Gail A. Eskes. "Development of the Halifax Visual Scanning Test: A New Measure of Visual-Spatial Neglect for Personal, Peripersonal, and Extrapersonal Space." Journal of the International Neuropsychological Society 25, no. 05 (April 16, 2019): 490–500. http://dx.doi.org/10.1017/s135561771900002x.

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Objectives: Visual-spatial neglect is a common attentional disorder after right-hemisphere stroke and is associated with poor rehabilitation outcomes. The presence of neglect symptoms has been reported to vary across personal, peripersonal, and extrapersonal space. Currently, no measure is available to assess neglect severity equally across these spatial regions and may be missing subsets of symptoms or patients with neglect entirely. We sought to provide initial construct validity for a novel assessment tool that measures neglect symptoms equally for these spatial regions: the Halifax Visual Scanning Test (HVST). Methods: In Study I, the HVST was compared to conventional measures of neglect and functional outcome scores (wheelchair navigation) in 15 stroke inpatients and 14 healthy controls. In Study II, 19 additional controls were combined with the control data from Study I to establish cutoffs for impairment. Patterns of neglect in the stroke group were examined. Results: In Study I, performance on all HVST subtests were correlated with the majority of conventional subtests and wheelchair navigation outcomes. In Study II, neglect-related deficits in visual scanning showed dissociations across spatial regions. Four inpatients exhibited symptoms of neglect on the HVST that were not detected on conventional measures, one of which showed symptoms in personal and extrapersonal space exclusively. Conclusions: The HVST appears a useful measure of neglect symptoms in different spatial regions that may not be detected with conventional measures and that correlates with functional wheelchair performance. Preliminary control data are presented and further research to add to this normative database appears warranted. (JINS, 2019, 25, 490–500)

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Janssen, Rowie J. F., Riemer J. K. Vegter, Han Houdijk, Lucas H. V. Van der Woude, and Sonja de Groot. "Evaluation of a standardized test protocol to measure wheelchair-specific anaerobic and aerobic exercise capacity in healthy novices on an instrumented roller ergometer." PLOS ONE 17, no. 9 (September 6, 2022): e0274255. http://dx.doi.org/10.1371/journal.pone.0274255.

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This study aims to evaluate whether a test protocol with standardized and individualized resistance settings leads to valid wheelchair Wingate tests (WAnT) and graded exercise tests (GXT) in healthy novices. Twenty able-bodied individuals (10M/10F, age 23 ± 2 years, body mass 72 ± 11 kg) performed an isometric strength test, sprint test, WAnT and GXT on a wheelchair ergometer. Using a previously developed set of regression equations, individuals’ isometric strength outcome was used to estimate the WAnT result (P30est), from which an effective individual WAnT resistance was derived. The subsequently measured WAnT outcome (P30meas) was used to estimate the GXT outcome (POpeakest) and to scale the individual GXT resistance steps. Estimated and measured outcomes were compared. The WAnT protocol was considered valid when maximal velocity did not exceed 3 m·s-1; the GXT protocol was considered valid when test duration was 8–12 min. P30est did not significantly differ from P30meas, while one participant did not have a valid WanT, as maximal velocity exceeded 3 m·s-1. POpeakest was 10% higher than POpeakmeas, and six participants did not reach a valid GXT: five participants had a test duration under 8 min and one participant over 12 min. The isometric strength test can be used to individually scale the WAnT protocol. The WAnT outcome scaled the protocol for the GXT less accurately, resulting in mostly shorter-than-desired test durations. In conclusion, the evaluated standardized and individualized test protocol was valid for the WAnT but less valid for the GXT among a group of novices. Before implementing the standardized individual test protocol on a broader scale, e.g. among paralympic athletes, it should be evaluated among different athletic wheelchair-dependent populations.

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Kirby, R. Lee, Janneke Swuste, Debbie J. Dupuis, Donald A. MacLeod, and Randi Monroe. "The Wheelchair Skills Test: A pilot study of a new outcome measure." Archives of Physical Medicine and Rehabilitation 83, no. 1 (January 2002): 10–18. http://dx.doi.org/10.1053/apmr.2002.26823.

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Mason, Barry, Martin Warner, Simon Briley, Victoria Goosey-Tolfrey, and Riemer Vegter. "Managing shoulder pain in manual wheelchair users: a scoping review of conservative treatment interventions." Clinical Rehabilitation 34, no. 6 (May 12, 2020): 741–53. http://dx.doi.org/10.1177/0269215520917437.

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Objective: To review the literature that has explored conservative treatments for the management of shoulder pain in manual wheelchair users. Methods: Five databases were systematically searched in february 2020 for terms related to shoulder pain and manual wheelchair use. Articles were screened and included if they investigated the conservative treatment of shoulder pain in wheelchair users. Participants’ physical characteristics, experimental design and primary and secondary outcome measures were extracted from studies. Studies were grouped according to treatment type to identify gaps in the literature and guide future research. Results: The initial search identified 407 articles, of which 21 studies met the inclusion criteria. Exercise-based treatment interventions were most prevalent ( n = 12). A variety of exercise modalities were employed such as strengthening and stretching ( n = 7), ergometer training ( n = 3), Pilates classes ( n = 1) and functional electrical stimulation ( n = 1). Only three studies supplemented exercise with an additional treatment type. The Wheelchair Users Shoulder Pain Index was used by 18 studies as the primary measure of shoulder pain. Only seven of these included an objective measure of shoulder function. Participant characteristics varied among studies, and physical activity levels were frequently not reported. Conclusions: Despite the high prevalence of shoulder pain in manual wheelchair users, the number of studies to have explored conservative treatment types is low. Exercise is the most commonly used treatment, which is encouraging as physical inactivity can exacerbate other health conditions. Few studies have adopted interdisciplinary treatment strategies or included objective secondary measures to better understand the mechanisms of pain.

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Fu, Jimmy Chun-Ming, Pin-Kuei Fu, and Yuan-Yang Cheng. "Benefits of Cycling Wheelchair Training for Elderly with Physical Disability: A Prospective Cohort Study." International Journal of Environmental Research and Public Health 19, no. 24 (December 14, 2022): 16773. http://dx.doi.org/10.3390/ijerph192416773.

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Aim: In order to investigate the effect of cycling wheelchair training as an exercise for aged 65+ disabled patients on cognitive function, quality of life, aerobic capacity and physiological parameters. Methods: Participants in nursing home performed cycling wheelchair training for 30 min a day, 5 days a week, for a total of 4 weeks. The main outcome measure was the short form 12 survey (SF-12). Other outcome measures included the Mini-Mental State Examination (MMSE), aero bike work rate test, resting blood pressure, and heart rate. Results: In this study, 41 volunteers were recruited and no participants dropped out of the study voluntarily during training, and no serious adverse effect was identified. Physical and mental component summary total scores of SF-12 were significantly higher after training with statistical significance (p = 0.001). 8 subscales also showed significant improvements after training (p = 0.025 ~ <0.001). Total MMSE score has no difference before and after training. Attention/calculation (p = 0.018), short term memory (p = 0.041), and aerobic capacity (p < 0.001) as measured by subscales of MMSE and aero bike test showed marked improvements, while resting systolic blood pressure (p = 0.931) and heart rate (p = 0.793) did not change. Conclusions: Cycling wheelchair is practical for the disabled elderly to exercise, and a 4-week exercise program enhanced their quality of life and aerobic capacity.

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Rushton, Paula W., Delphine Labbé, Louise Demers, William C. Miller, William B. Mortenson, and R. Lee Kirby. "Understanding the Burden Experienced by Caregivers of Older Adults Who Use a Powered Wheelchair: A Cross-Sectional Study." Gerontology and Geriatric Medicine 3 (January 1, 2017): 233372141770373. http://dx.doi.org/10.1177/2333721417703736.

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Objective: In this study, we aimed to describe the burden of family caregivers providing powered wheelchair-related and overall assistance and test the hypotheses that caregiver burden correlates with participation, wheelchair skills capacity, anxiety, depression, and social support. Methods: Cross-sectional study. Participants included 35 family caregivers of powered wheelchair users. Caregivers were assessed using the Power Mobility Caregiver Assistive Technology Outcome Measure, Late Life Disability Instrument, Wheelchair Skills Test Questionnaire for caregivers, Hospital Anxiety and Depression Scale, and Interpersonal Support Evaluation List–12. Results: The most burdensome powered wheelchair assistance items were providing verbal hints/directions, needing to be nearby, anxiety, and fear that user may be harmed. The most burdensome overall assistance item was feeling limited in recreational/leisure activities. Caregiver burden was significantly correlated with participation limitations, anxiety, depression, and social support. Discussion: Caregivers experience burden for wheelchair-related and overall help, especially psychological burden. Such results have implications for the type of resources required to support family caregivers.

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Miller, W. C., J. Garden, and W. B. Mortenson. "Measurement properties of the wheelchair outcome measure in individuals with spinal cord injury." Spinal Cord 49, no. 9 (May 17, 2011): 995–1000. http://dx.doi.org/10.1038/sc.2011.45.

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Fliess-Douer, Osnat, Yves C. Vanlandewijck, Galia Lubel Manor, and Lucas HV Van Der Woude. "A systematic review of wheelchair skills tests for manual wheelchair users with a spinal cord injury: towards a standardized outcome measure." Clinical Rehabilitation 24, no. 10 (June 16, 2010): 867–86. http://dx.doi.org/10.1177/0269215510367981.

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Lamers, Ilse, Lore Kerkhofs, Joke Raats, Daphne Kos, Bart Van Wijmeersch, and Peter Feys. "Perceived and actual arm performance in multiple sclerosis: relationship with clinical tests according to hand dominance." Multiple Sclerosis Journal 19, no. 10 (February 13, 2013): 1341–48. http://dx.doi.org/10.1177/1352458513475832.

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Background: The real-life relevance of frequently applied clinical arm tests is not well known in multiple sclerosis (MS). Objective: This study aimed to determine the relation between real-life arm performance and clinical tests in MS. Methods: Thirty wheelchair-bound MS patients and 30 healthy controls were included. Actual and perceived real-life arm performance was measured by using accelerometry and a self-reported measure (Motor Activity Log). Clinical tests on ‘body functions & structures’ (JAMAR handgrip strength, Motricity Index (MI), Fugl Meyer (FM)) and ‘activity’ level (Nine Hole Peg Test (NHPT), Action Research Arm test) of the International Classification of Functioning were conducted. Statistical analyses were performed separately for current dominant and non-dominant arm. Results: For all outcome measures, MS patients scored with both arms significantly lower than the control group. Higher correlations between actual arm performance and clinical tests were found for the non-dominant arm (0.63–0.80). The FM (55%) was a good predictor of actual arm performance, while the MI (46%) and NHPT (55%) were good predictors of perceived arm performance. Conclusions: Real-life arm performance is decreased in wheelchair-bound MS patients and can be best predicted by measures on ‘body functions & structures’ level and fine motor control. Hand dominance influenced the magnitude of relationships.

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Kim, M. J., and K. Y. Park. "A Study on Reliability and Validity of K-WhOM(Korean-translated version of Wheelchair Outcome Measure)." Journal of Rehabilitation Welfare Engineering & Assistive Technology 13, no. 4 (November 30, 2019): 340–50. http://dx.doi.org/10.21288/resko.2019.13.4.340.

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Rushton, Paula W., Emma M. Smith, William C. Miller, R. Lee Kirby, and Geneviève Daoust. "Reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting wheelchair skills (SEATS) outcome measure." Disability and Rehabilitation: Assistive Technology 14, no. 3 (January 31, 2018): 250–54. http://dx.doi.org/10.1080/17483107.2018.1428370.

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Moran, Ryan N., Steven P. Broglio, Karla K. Francioni, and Jacob J. Sosnoff. "Exploring Baseline Concussion-Assessment Performance in Adapted Wheelchair Sport Athletes." Journal of Athletic Training 55, no. 8 (June 30, 2020): 856–62. http://dx.doi.org/10.4085/1062-6050-294-19.

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Context With growing awareness of and advocacy for including individuals with disabilities in sport, implementation of concussion-assessment and -management strategies is warranted. Limited research is available on concussion assessment in adapted wheelchair sport athletes. Objective To examine baseline symptom reporting, computerized neurocognitive testing, and a modified balance scoring system in adapted athletes. A secondary objective was to provide preliminary normative data for this population. Design Cross-sectional study. Setting University athletic training room and computer laboratory. Patients or Other Participants Twenty-one athletes (age = 22.1 ± 3.0 years) from 1 institution's collegiate adapted athletics program. Main Outcome Measure(s) Athletes completed baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) and the Wheelchair Error Scoring System (WESS) before the start of their respective seasons. Symptom reporting variables consisted of total symptoms, symptom severity scores, and baseline symptom factors (eg, vestibular-somatic, sleep arousal, cognitive-sensory, and affective). We analyzed ImPACT composite scores of verbal memory, visual memory, visual motor processing speed, and reaction time and impulse control to determine neurocognitive function. Balance performance was quantified using the WESS condition and overall errors. Results Compared with normative reference values, 17 (81%) of adapted athletes reported greater symptoms and 20 (95%) performed at or below average on at least 1 neurocognitive composite score. Mean errors on the WESS were 3.14 ± 2.9, with 81% committing ≥1 error. Sex differences were not present for symptoms, neurocognitive testing, or balance measures. Conclusions Our findings provide context for baseline performance in adapted athletes and help to further develop the WESS as an assessment of balance in these athletes.

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Alimohammad, Samaneh, Shahriar Parvaneh, Setareh Ghahari, Hooshang Saberi, Mir Saeed Yekaninejad, and William C. Miller. "Translation and validation of the Farsi version of the Wheelchair Outcome Measure (WhOM-Farsi) in individuals with spinal cord injury." Disability and Health Journal 9, no. 2 (April 2016): 265–71. http://dx.doi.org/10.1016/j.dhjo.2015.09.004.

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Gagnon, Dany, Simon Décary, and Marie-France Charbonneau. "The Timed Manual Wheelchair Slalom Test: A Reliable and Accurate Performance-Based Outcome Measure for Individuals With Spinal Cord Injury." Archives of Physical Medicine and Rehabilitation 92, no. 8 (August 2011): 1339–43. http://dx.doi.org/10.1016/j.apmr.2011.02.005.

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Auger, C., L. Demers, I. Gélinas, F. Routhier, WB Mortenson, and WC Miller. "Reliability and validity of the telephone administration of the wheelchair outcome measure (WhOM) for middle-aged and older users of power mobility devices." Journal of Rehabilitation Medicine 42, no. 6 (2010): 574–81. http://dx.doi.org/10.2340/16501977-0557.

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Hossain, K. M. Amran, Mohamed Sakel, Karen Saunders, M. Feroz Kabir, and M. Abu Khayer Hasnat. "Rehabilitation of a young girl with acute transverse myelitis and prolonged lower motor neuron features: a longitudinal case report over 12 months." International Journal of Therapy and Rehabilitation 29, no. 1 (January 2, 2022): 1–10. http://dx.doi.org/10.12968/ijtr.2020.0049.

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Background This report describes an effective rehabilitation programme for a 13-year-old girl, diagnosed with acute transverse myelitis, as an example of best clinical practice. Case description Miss A was admitted to the National Institute of Neurosciences and Hospital in Dhaka, where she was diagnosed with acute transverse myelitis, in September 2018. She was discharged and referred for intensive rehabilitation over 3 months as an outpatient at the Centre for the Rehabilitation of the Paralysed in Bangladesh. The therapy team conducted a baseline assessment before starting treatment, which included the following outcome measures: the International Standards for Neurological Classification of Spinal Cord Injury Scale; Spinal Cord Independence Measure; and the Spinal Cord Injury Functional Ambulation Inventory. After 3 months, Miss A was discharged home to continue with a home exercise programme supported by her parents. Outcome measurements were repeated at 3-, 6- and 12-month time points. Results Miss A regained muscle power in her legs and normal sensation in S4/5 dermatomes, in addition to regaining voluntary anal muscle contraction. Her mobility and transfers improved so that she was able to transfer in and out of her wheelchair independently and use two elbow crutches to walk short distances outdoors. Conclusions This report shows that it is possible for a child who had been severely disabled by acute transverse myelitis to make substantial physical improvements up to 12 months after diagnosis when provided with effective rehabilitation. It also identifies that rehabilitation can provide multiple benefits and value for the individual patient, family, community and society.

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Groot, Sonja de, Linda J. Valent, Richard Fickert, Babette M. Pluim, and Han Houdijk. "An Incremental Shuttle Wheel Test for Wheelchair Tennis Players." International Journal of Sports Physiology and Performance 11, no. 8 (November 2016): 1111–14. http://dx.doi.org/10.1123/ijspp.2015-0598.

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Purpose:To determine the relationship between outcomes of the shuttle wheel test (SWT) and peak oxygen uptake (VO2peak) during that test and whether SWT and VO2peak can discriminate between different skill levels of wheelchair tennis players. Methods:Fifteen wheelchair tennis players performed an SWT on a tennis court while VO2 was measured continuously. Outcome measures were VO2peak and achieved stage. Relations between outcomes and Dutch wheelchair tennis ranking were calculated with Spearman correlation. Independent t tests were used to test for differences between national and international players. Results:Moderate correlations were found between VO2peak and SWT outcome (r = .40–.47). The tennis ranking correlated weakly with VO2peak (r = –.35) and strongly with SWT outcome (r = –.80). A significant difference was found between national and international players for achieved stage (P = .027) and VO2peak (P = .027). Conclusions:The SWT outcome only explained a small part of the variance in VO2peak among players, so it cannot be considered a valid test for aerobic capacity. However, SWT outcomes are related to the skill level of the player and give a good indication of the overall peak wheelchair performance.

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Guy, Lisette, Sean Gorman, Jennifer Wilson, Temeika Jackson, Demelza Petty, Simon Harrison, and Susannah Pick. "#3031 Outcome and evaluation of an outpatient multidisciplinary group-based rehabilitative therapy programme for functional neurological disorder." Journal of Neurology, Neurosurgery & Psychiatry 92, no. 8 (July 16, 2021): A12.2—A12. http://dx.doi.org/10.1136/jnnp-2021-bnpa.29.

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AimsWe report findings from an eight-week rehabilitative therapy programme, delivered in a neuropsychiatric outpatient setting, with co-primary aims to (1) reduce symptom severity, and (2) improve functional mobility, in selected adults with a diagnosis of Functional Neurological Disorder (FND). Effectiveness of the programme was assessed in regard to outcome data routinely collected throughout the programme, and at three-month follow-up.MethodFollowing appropriate referral, criteria screening and initial assessment, suitable individuals attended as day patients for two days per week over an eight-week period, and a follow-up session provided at three months. The programme comprised individual sessions of Physiotherapy (PT), Cognitive Behavioural Therapy (CBT) and self-management, as well as group physiotherapy workshops and psycho-educational sessions. Outcome measures included the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-ii), Work and Social Adjustment Scale (WSAS), and clinician-rated observation of mobility-aid requirement. Mobility-aid requirement was categorised as follows: unaided, walking-aid, and wheelchair user. Analyses included only data from individuals completing both treatment and follow-up (n = 31). Friedmans ANOVA assessed overall change in outcome measure scores over time. Dunn-Bonferroni post-hoc tests were used to compare pairs of time-points (Weeks 1, 8, three-month follow-up).ResultsThere were statistically significant overall improvements on the BAI,χ2(2) = 15.35, p <.001,BDI-ii,χ2(2) = 24.61, p <.001,WSAS,χ2(2) = 24.61, p =.001, and in category of mobility-aid requirement, χ2(2) = 19.50, p <.001.Descriptive statistics indicated that 45% of patients could mobilise unaided prior to programme attendance, with 84%able to mobilise unaided at follow-up. Post-hoc Dunn-Bonferroni tests indicated that reductions in scores were significant between Week 1 and Week 8 for the BAI, p =.004, BDI-ii, p <.001, and WSAS, p =.004, and between Week 1 and three-month follow-up for the BAI, p =.002, BDI-ii, p =.001, and WSAS, p =.006.ConclusionsThese findings suggest that an outpatient rehabilitative therapy programme can be a beneficial treatment approach, as patients reported reduced symptom severity in terms of anxiety, depression, and functional impairment, as demonstrated by scores on the BAI, BDI-ii and WSAS, and displayed improvements in mobility, as determined by reduced mobility-aid requirement. Although further evaluation would be encouraged to address limitations of these findings, they serve as a positive indication of an effective alternative to inpatient treatment.

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Possover, M. "Humans at the dawn of the in-body electrical nerve stimulation era." Facts, Views and Vision in ObGyn 14, no. 4 (December 30, 2022): 293–98. http://dx.doi.org/10.52054/fvvo.14.4.041.

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Background: The neuroprosthesis laparoscopic implantation technique for electric pelvic nerve stimulation was introduced to gynaecology over 15 years ago to treat intractable pelvic neuropathic pain. Following this first indication, other applications were developed, particularly in parapleology. The LION procedure developed to assist patients with paraplegia and common problems associated with inertia when confined to a wheelchair could find revolutionary applications in aging medicine and prevention. Material and Methods: Spinal cord injured patients who have undergone the Possover’s LION procedure. Main outcome measure: PubMed was systematically searched to identify peer-reviewed articles published in English that reported on LION procedure. Results: Three independent studies published recently (100 patients worldwide) have shown revolutionary recovery of supra-spinal control in patients with chronic spinal cord injury following pelvic nerves stimulation, with 70% of them establishing a walker/crutches-assisted gait. The same studies have also shown significant whole-body muscle-mass building, peripheral vasodilatation, and an unexpected improvement in bone mineral density. Conclusion: These ground-breaking findings could find revolutionary applications in aging medicine and the prevention of osteoporosis, with a huge impact on global public health. Humanity is on the cusp of an exciting new era following the introduction of the in-body electrical nerve stimulation technique. What’s new? In-body electrical nerve stimulation for recovery and/or control of human peripheral somatic and autonomic nervous systems.

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van Silfhout, Lysanne, Allard J. F. Hosman, Ronald H. M. A. Bartels, Michael J. R. Edwards, Rainer Abel, Armin Curt, and Henk van de Meent. "Ten Meters Walking Speed in Spinal Cord–Injured Patients: Does Speed Predict Who Walks and Who Rolls?" Neurorehabilitation and Neural Repair 31, no. 9 (August 8, 2017): 842–50. http://dx.doi.org/10.1177/1545968317723751.

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Background. Walking speed is assumed to be a key factor in regaining ambulation after spinal cord injury (SCI). However, from the literature it remains unclear which walking speed usually results in independent community ambulation. Objective. The primary aim of this study was to determine at which walking speed SCI patients tend to walk in the community instead of using a wheelchair. The secondary aim was to investigate clinical conditions that favor independent ambulation in the community. Methods. Data from SCI patients were collected retrospectively from the European Multicenter Study about Spinal Cord Injury database. We determined a cutoff walking speed at which the patients tend to walk in the community by plotting a receiver operating characteristics curve, using the Spinal Cord Independence Measure for outdoor mobility. Univariate analyses investigated which factors influence independent community ambulation. Results. A walking speed of 0.59 m/s is the cutoff between patients who do and do not ambulate independently in the community, with a sensitivity of 91.6% and a specificity of 80.3%. Age, injury severity, and lower limb muscle strength have a significant influence on independent community ambulation. Conclusions. Patients with an SCI who regain a walking speed of 0.59 m/s tend to achieve a level of walking effectiveness that allows for independent community walking. Although such patients tend to be younger and less severely injured, this walking speed can be a target for locomotor training in rehabilitation and clinical trials that lead to a meaningful outcome level of community walking.

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Dupraz, Julien, Karen Andersen-Ranberg, Stefan Fors, Marie Herr, Francois R. Herrmann, Tomoko Wakui, Bernard Jeune, Jean-Marie Robine, Yasuhiko Saito, and Brigitte Santos-Eggimann. "Use of healthcare services and assistive devices among centenarians: results of the cross-sectional, international 5-COOP study." BMJ Open 10, no. 3 (March 2020): e034296. http://dx.doi.org/10.1136/bmjopen-2019-034296.

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ObjectivesTo measure the use of healthcare services and assistive devices by centenarians in five countries.DesignCross-sectional study using a survey questionnaire.SettingCommunity-dwelling and institutionalised centenarians living in Japan, France, Switzerland, Sweden and Denmark.Participants1253 participants aged 100 or in their 100th year of life, of whom 1004 (80.1%) were female and 596 (47.6%) lived in institutions.Main outcome measuresRecent use of medical visits, nursing care at home, home-delivered meals, acute care hospital stays overnight, professional assessments such as sight tests, mobility aids and other assistive devices. A set of national healthcare system indicators was collected to help interpret differences between countries.ResultsThere was considerable variability in the healthcare services and assistive devices used by centenarians depending on their country and whether they were community-dwelling or institutionalised. In contrast to the relatively homogeneous rates of hospitalisation in the past year (around 20%), community-dwelling centenarians reported widely ranging rates of medical visits in the past 3 months (at least one visit, from 32.2% in Japan to 86.6% in France). The proportion of community-dwellers using a mobility device to get around indoors (either a walking aid or a wheelchair) ranged from 48.3% in Japan to 79.2% in Sweden. Participants living in institutions and reporting the use of a mobility device ranged from 78.6% in Japan to 98.2% in Denmark.ConclusionsOur findings suggest major differences in care received by centenarians across countries. Some may result from the characteristics of national healthcare systems, especially types of healthcare insurance coverage and the amounts of specific resources available. However, unexplored factors also seem to be at stake and may be partly related to personal health and cultural differences.

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Giwnewer, Uriel, Guy Rubin, Alex Friedman, and Nimrod Rozen. "User Assessment of a Novel Suspension for a Wheelchair—A Prospective, Randomized, Double Blind Trial." Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145932098326. http://dx.doi.org/10.1177/2151459320983268.

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Background: Many Wheelchair users experience adverse effects specific to their situation, some of which might be avoided if suspension systems are integrated into the wheelchair. Objectives: Our study aimed to compare the user experience using a novel wheelchair suspension system with normal wheels. We tried to quantify the user feelings and impressions while using the different wheels. Study Design: Double blinded comparative randomized study. Methods: The patients were randomized into 2 groups. One used shock absorbing wheels, and the other group had a set of standard wheels with the same exact wheelchairs. The patients were taken to a daily trip by the caregivers and given questionnaires in the second and fourth days. On the morning of the third day the wheels were interchanged, creating a cross over between the groups. We collected general and medical information from the participants. The main outcome measures were the questionnaires filled by the patients and the caregivers aiming to quantify the user experience with the suspension equipped wheels. Results: Statistical significance was reached in 2 questions referred to the patients: “In general—During the ride I didn’t feel the bumps” and “I feel very confident when riding the chair” and in one question referred to the caregiver—“It was easy to push the chair in suboptimal ground.” Conclusions: We conclude that the shock absorbing system provided a better user experience in the immediate term than standard wheels. Further study is needed to assess the long-term implications.

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Wanner, Addie, Camilo Castillo, Rachel Torres, and Daniela Terson de Paleville. "ASYMPTOMATIC DYSREFLEXIA AFTER POSTURAL CHANGES IN AN INCOMPLETE SPINAL CORD INJURY: CONSIDERATIONS FOR EXERCISE PHYSIOLOGISTS." Journal of Clinical Exercise Physiology 12, s1 (January 1, 2023): 11. http://dx.doi.org/10.31189/2165-7629-12-s1.11.

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BACKGROUND Autonomic dysreflexia (AD) is a potentially life threatening hypertensive syndrome prevalent among patients with chronic spinal cord injuries (SCI) at spinal segment T6 or above. AD is due to the loss of supraspinal control over sympathetic preganglionic neurons and is triggered by noxious stimuli below the level of injury. The treatment of AD is multifaceted, from conservative management to topical and oral antihypertensive medications. Understanding AD's rapid onset and severity are extremely important for exercise physiologists working with patients with SCI. CASE PRESENTATION A 67-year old male with chronic motor incomplete cervical SCI (i.e., ASIA C4 C) and persistent orthostatic hypotension (OH) was enrolled in a study to determine the effects of biofeedback on blood pressure (BP) modulation when an episode of asymptomatic AD occurred. Baseline and resting BP were recorded at 122/82, with a resting mean arterial pressure (MAP) of 96. The BP was continuously monitored using a telemetric device (Caretaker, Charlottesville, VA). Upon positional changes required to measure OH with a tilt table, the participant showed an antagonist response with a sudden increase in BP consistent with AD symptoms, reaching a maximum level of 199/121. The participant was asymptomatic during the AD episode. CASE MANAGEMENT/OUTCOME BP returned to baseline levels after the participant was transferred back to a seated position in the wheelchair without using other measurements or medications. The titl test was modified with the participant positioned in a semi supine position (30° incline) and then tilted to approximately 45and remained in this position for 3 minutes. DISCUSSION AD is prevalent among people with cervical or upper thoracic SCI, and often the episodes are asymptomatic. As a part of the training routine, many patients with SCI are placed in a supine position for passive stretching and exercising. We are presenting data on this episode of asymptomatic AD due to postural changes to bring awareness to exercise physiologists of this life threatening condition. Trainers should carefully check for signs of AD in this population and measure BP often during the training sessions if a continuous assessment of BP is unavailable. Seated is recommended over a supine or semi-supine position. This could be accomplished by using physical therapy wedge cushions to maintain blood pressure homeostasis.

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van der Slikke, Rienk M. A., Daan J. J. Bregman, Monique A. M. Berger, Annemarie M. H. de Witte, and Dirk-Jan (H ). E. J. Veeger. "The Future of Classification in Wheelchair Sports: Can Data Science and Technological Advancement Offer an Alternative Point of View?" International Journal of Sports Physiology and Performance 13, no. 6 (July 1, 2018): 742–49. http://dx.doi.org/10.1123/ijspp.2017-0326.

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Purpose: Classification is a defining factor for competition in wheelchair sports, but it is a delicate and time-consuming process with often questionable validity. New inertial sensor-based measurement methods applied in match play and field tests allow for more precise and objective estimates of the impairment effect on wheelchair-mobility performance. The aim of the present research was to evaluate whether these measures could offer an alternative point of view for classification. Methods: Six standard wheelchair-mobility performance outcomes of different classification groups were measured in match play (n = 29), as well as best possible performance in a field test (n = 47). Results: In match results, a clear relationship between classification and performance level is shown, with increased performance outcomes in each adjacent higher-classification group. Three outcomes differed significantly between the low- and mid-classified groups, and 1, between the mid- and high-classified groups. In best performance (field test), there was a split between the low- and mid-classified groups (5 out of 6 outcomes differed significantly) but hardly any difference between the mid- and high-classified groups. This observed split was confirmed by cluster analysis, revealing the existence of only 2 performance-based clusters. Conclusions: The use of inertial sensor technology to obtain objective measures of wheelchair-mobility performance, combined with a standardized field test, produced alternative views for evidence-based classification. The results of this approach provide arguments for a reduced number of classes in wheelchair basketball. Future use of inertial sensors in match play and field testing could enhance evaluation of classification guidelines, as well as individual athlete performance.

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Kenny, Siobhan, and Rosemary Joan Gowran. "Outcome Measures for Wheelchair and Seating Provision: A Critical Appraisal." British Journal of Occupational Therapy 77, no. 2 (February 2014): 67–77. http://dx.doi.org/10.4276/030802214x13916969447119.

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Tognolo, Lucrezia, Alfredo Musumeci, Andrea Pignataro, Nicola Petrone, Michael Benazzato, Francesco Bettella, Giuseppe Marcolin, Antonio Paoli, and Stefano Masiero. "The Relationship between Clinical Tests, Ultrasound Findings and Selected Field-Based Wheelchair Skills Tests in a Cohort of Quadriplegic Wheelchair Rugby Athletes: A Pilot Study." Applied Sciences 11, no. 9 (May 2, 2021): 4162. http://dx.doi.org/10.3390/app11094162.

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Manual wheelchair use may determine shoulder joint overload and rotator cuff injury. Chronic shoulder pathologies can also influence the propulsion ability of wheelchair athletes with spinal cord injury (SCI) during sport activities. However, the relationship between shoulder pathology and wheelchair performances has never been explored. Therefore, the study aimed to investigate the correlation between shoulder pathologic findings with clinical tests and ultrasonography evaluation and the results of wheelchair performance tests. Nineteen quadriplegic wheelchair rugby players were evaluated to investigate the association between clinical and ultrasound shoulder pathologic findings and their correlation with the performance of field-based selected wheelchair skills tests (WSTs). The outcome measures were the International Wheelchair Rugby Classification Score, dominant and non-dominant Physical Examination Shoulder Score, and dominant and non-dominant Ultrasound Shoulder Pathology Rating Scale (USPRS). The WST was measured at the beginning and at one-year follow-up. A statistically significant correlation was found between the time since SCI and dominant USPRS (p < 0.005). The non-dominant USPRS was strongly related to WST at the beginning (p < 0.005) and the end of the study (p < 0.05). Data suggest that the severity of the non-dominant shoulder pathology detected on the ultrasound is related to lower performance on the WST. Chronic manual wheelchair use could be responsible for dominant SCI shoulder joint and rotator cuff muscle damage, while non-dominant USPRS could be related to performance on the WST.

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Shin, Ji Cheol, Eun Joo Kim, Chang Il Park, Eun Sook Park, and Kyoo-Ho Shin. "Clinical Features and Outcomes Following Bilateral Lower Limb Amputation in Korea." Prosthetics and Orthotics International 30, no. 2 (August 2006): 155–64. http://dx.doi.org/10.1080/03093640600608074.

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The objectives of this study were to evaluate the clinical features and outcomes of 43 bilateral lower limb amputees. The clinical features obtained included the causes of amputation, level of amputation, concurrent medical problems, and stump condition. Outcome measures were obtained using the activities of daily living (ADL) index, the Frenchay Activities Index (FAI), and mobility grading with prostheses or wheelchair. Of 33 amputees who were prosthetic ambulators, 22 (67%), mainly bilateral trans-tibial (TT) amputees, were community ambulators, and participated in activities which included stair-walking, and six of 11 household ambulators were combination trans-femoral (TF) and TT amputees. Of 10 amputees who were wheelchair ambulators, only one was able to perform wheelchair transfers independently and five were independent wheelchair ambulators. Using the ADL index and FAI, there was no significant difference in scores according to the level of amputation ( p > 0.05), but the scores of community prosthetic ambulators were significantly higher than those of wheelchair ambulators ( p < 0.05). Age was found to be negatively correlated with ADL index and FAI scores ( r = −0.518 vs. r = −0.550) ( p < 0.01). This study concludes that overall independence in ADL after bilateral lower limb amputation improved with young age and prosthetic mobility.

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Yassin, Mustafa, Avraham Garti, Muhammad Khatib, Moshe Weisbrot, and Dror Robinson. "Retentive Cup Arthroplasty in Selected Hip Fracture Patients—A Prospective Series With a Minimum 3-Year Follow-Up." Geriatric Orthopaedic Surgery & Rehabilitation 7, no. 4 (August 19, 2016): 178–82. http://dx.doi.org/10.1177/2151458516661384.

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Objective: To evaluate the efficacy of the use of retentive cup primary total hip replacement (THR) in high-dislocation risk subcapital fracture patients. Methods: During the years 2008 to 2012, 354 patients with displaced subcapital fracture were operated at our institute. The patients were selected to undergo primary constrained THR according to the following criteria: (1) a preinjury grade 4 or more on the Functional Independence Measure mobility item “5. Locomotion: walking/wheelchair” and grade 4 is defined as “4. Minimal assistance Requiring incidental hands-on help only” (patient performs >75% of the task) and (2) a disease leading to poor motor control. Exclusion criteria were normal muscular control and known infection of the involved joint. Results: Of the 354 patients, 87 fulfilled the inclusion criteria and underwent constrained total hip. Average age was 78 years with a female predominance (73%). Fifteen patients had prior hemiparesis, 19 had Parkinson disease, and 35 had generalized sarcopenia. Eighty-five patients had an uneventful recovery, with an average Hip Disability and Osteoarthritis Outcome Score (HOOS) of 76 ± 7 at 2 years. In 2 patients, the prostheses dislocated. In both cases, the dislocation was due to ring displacement and the inner head dislocated. One case was infected and the patient was treated by a Girdlestone procedure. In the other case, the prosthetic head was revised. The patient remained asymptomatic and at 4-year follow-up had an HOOS of 85. Discussion: It appears that constrained prosthesis is a suitable treatment for patients with poor muscular control having subcapital fractures. The functional results appear to be superior to those of bipolar arthroplasty and similar to the results of primary total hip arthroplasty while the dislocation risk is <3%. Conclusion: Semielective total hip arthroplasty using a retentive cup liner appears to offer good functional results with a low dislocation rate in patients with poor muscular control.

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van der Slikke, Rienk M. A., Monique A. M. Berger, Daan J. J. Bregman, and Dirkjan H. E. J. Veeger. "Wearable Wheelchair Mobility Performance Measurement in Basketball, Rugby, and Tennis: Lessons for Classification and Training." Sensors 20, no. 12 (June 21, 2020): 3518. http://dx.doi.org/10.3390/s20123518.

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Athlete impairment level is an important factor in wheelchair mobility performance (WMP) in sports. Classification systems, aimed to compensate impairment level effects on performance, vary between sports. Improved understanding of resemblances and differences in WMP between sports could aid in optimizing the classification methodology. Furthermore, increased performance insight could be applied in training and wheelchair optimization. The wearable sensor-based wheelchair mobility performance monitor (WMPM) was used to measure WMP of wheelchair basketball, rugby and tennis athletes of (inter-)national level during match-play. As hypothesized, wheelchair basketball athletes show the highest average WMP levels and wheelchair rugby the lowest, whereas wheelchair tennis athletes range in between for most outcomes. Based on WMP profiles, wheelchair basketball requires the highest performance intensity, whereas in wheelchair tennis, maneuverability is the key performance factor. In wheelchair rugby, WMP levels show the highest variation comparable to the high variation in athletes’ impairment levels. These insights could be used to direct classification and training guidelines, with more emphasis on intensity for wheelchair basketball, focus on maneuverability for wheelchair tennis and impairment-level based training programs for wheelchair rugby. Wearable technology use seems a prerequisite for further development of wheelchair sports, on the sports level (classification) and on individual level (training and wheelchair configuration).

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Wu, Jau-Ching, Wen-Cheng Huang, Yu-Chun Chen, Tsung-Hsi Tu, Yun-An Tsai, Shih-Fong Huang, Hsueh-Chen Huang, and Henrich Cheng. "Acidic fibroblast growth factor for repair of human spinal cord injury: a clinical trial." Journal of Neurosurgery: Spine 15, no. 3 (September 2011): 216–27. http://dx.doi.org/10.3171/2011.4.spine10404.

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Object The study aimed to verify the safety and feasibility of applying acidic fibroblast growth factor (aFGF) with fibrin glue in combination with surgical neurolysis for nonacute spinal cord injury. Methods This open-label, prospective, uncontrolled human clinical trial recruited 60 patients with spinal cord injuries (30 cervical and 30 thoracolumbar). The mean patient age was 36.5 ± 15.33 (mean ± SD) years, and the male/female ratio was 3:1. The mean time from injury to treatment was 25.7 ± 26.58 months, and the cause of injury included motor vehicle accident (26 patients [43.3%]), fall from a height (17 patients [28.3%]), sports (4 patients [6.7%]), and other (13 patients [21.7%]). Application of aFGF with fibrin glue and duraplasty was performed via laminectomy, and an adjuvant booster of combined aFGF and fibrin glue (2 ml) was given at 3 and 6 months postsurgery via lumbar puncture. Outcome measurements included the American Spinal Injury Association (ASIA) motor scores, sensory scores, impairment scales, and neurological levels. Examination of functional independence measures, visual analog scale, MR imaging, electrophysiological and urodynamic studies, hematology and biochemistry tests, tumor markers, and serum inflammatory cytokines were all conducted. All adverse events were monitored and reported. Exclusions were based on refusal, unrelated adverse events, or failure to participate in the planned rehabilitation. Results Forty-nine patients (26 with cervical and 23 with thoracolumbar injuries) completed the 24-month trial. Compared with preoperative conditions, the 24-month postoperative ASIA motor scores improved significantly in the cervical group (from 27.6 ± 15.55 to 37.0 ± 19.93, p < 0.001) and thoracolumbar group (from 56.8 ± 9.21 to 60.7 ± 10.10, p < 0.001). The ASIA sensory scores also demonstrated significant improvement in light touch and pinprick in both groups: from 55.8 ± 24.89 to 59.8 ± 26.47 (p = 0.049) and 56.3 ± 23.36 to 62.3 ± 24.87 (p = 0.003), respectively, in the cervical group and from 75.7 ± 15.65 to 79.2 ± 15.81 (p < 0.001) and 78.2 ± 14.72 to 82.7 ± 16.60 (p < 0.001), respectively, in the thoracolumbar group. At 24-month follow-up, the ASIA impairment scale improved significantly in both groups (30% cervical [p = 0.011] and 30% thoracolumbar [p = 0.003]). There was also significant improvement in neurological level in the cervical (from 5.17 ± 1.60 to 6.27 ± 3.27, p = 0.022) and thoracolumbar (from 18.03 ± 4.19 to 18.67 ± 3.96, p = 0.001) groups. The average sum of motor items in functional independence measure also had significant improvement in both groups (p < 0.05). The walking/wheelchair locomotion subscale showed increased percentages of patients who were ambulatory (from 3.4% to 13.8% and from 17.9% to 35.7% in the cervical and thoracolumbar groups, respectively). There were no related adverse events. Conclusions The use of aFGF for spinal cord injury was safe and feasible in the present trial. There were significant improvements in ASIA motor and sensory scale scores, ASIA impairment scales, neurological levels, and functional independence measure at 24 months after treatment. Further large-scale, randomized, and controlled investigations are warranted to evaluate the efficacy and long-term results.

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D. Thorat, Dr Komal. "Effectiveness of Virtual Rehabilitation on Functional Outcome for Wheel Chair Navigation in Patients with Spinal Cord Injury - A Pilot Study." International Journal of Science and Healthcare Research 7, no. 2 (June 30, 2022): 322–30. http://dx.doi.org/10.52403/ijshr.20220444.

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Spinal cord injury (SCI) is the injury of the spinal cord from the foramen magnum to the cauda equina which occurs as a result of compulsion, incision or contusion. Spinal cord injury patients lead to loss of functional outcome like balance, strength and general mobility because of which may lead to life threatening condition that carries a high risk of morbidity and mortality. Spinal cord injury patients (SCI) should undergo balance rehabilitation to restore the key determinants of ambulation, such as balance, strength, muscle tone, and proprioception. Recently, studies have used virtual reality (VR) as a promising tool for clinical rehabilitation in a variety of neurological disorders. Purpose: To evaluate the effect of virtual Rehabilitation on Functional Outcome for Wheel chair Navigation In patients with Spinal Cord Injury Methodology: Eight SCI patients with Cervical and Thoracic level Injury were included in this study. Patients were divided into two groups: Conventional Group (04patients) and Experimental +conventional Group (04 patients). Both groups underwent the conventional rehabilitation program. An additional training with VR therapy was conducted for 6 weeks with 20 minutes per session and 3 sessions per week. The outcome measures were Modified Functional Reach Test, Range of Motion of Upper Limb and Wheelchair Propulsion Test. Result: In this study Virtual Rehabilitation Group showed significant improvement in Balance, ROM and Wheelchair Propulsion compared to Conventional group (p <0.01 considered significant). Conclusion: Virtual Rehabilitation can be considered as adjunctive therapy for improving functional outcome for wheelchair navigation purpose. Keywords: Spinal Cord Injury, Virtual Rehabilitation, wheelchair navigation

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Abdul Rahim, Mohd Zulkifli, Ahmad Zamir Che Daud, and Nurul Akrami Ab Rahim Yang. "Wheelchair Skills Training: A scoping review." Environment-Behaviour Proceedings Journal 6, no. 17 (August 15, 2021): 165–72. http://dx.doi.org/10.21834/ebpj.v6i17.2879.

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This study aimed to examine the types of available evidence and knowledge gaps on wheelchair skills training among PWDs in literature. This study employed a scoping review method and was guided by Arksey and O'Malley's using five steps framework. A total of 15 peer-reviewed articles met the inclusion criteria. The results support the effectiveness of wheelchair skills training through personal feedbacks from participants, observation and the use of standardized outcome measures, including self-perceived assessment. This study highlights the importance and benefit of wheelchair skills training to wheelchair users, caregivers and health personnel. Keywords: Keywords: Skill Training; Disability; Wheelchair; Scoping Review eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i17.2879

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Mortenson, William B., William C. Miller, and Claudine Auger. "Issues for the Selection of Wheelchair-Specific Activity and Participation Outcome Measures: A Review." Archives of Physical Medicine and Rehabilitation 89, no. 6 (June 2008): 1177–86. http://dx.doi.org/10.1016/j.apmr.2008.01.010.

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Bergamini, Elena, Francesca Morelli, Flavia Marchetti, Giuseppe Vannozzi, Lorenzo Polidori, Francesco Paradisi, Marco Traballesi, Aurelio Cappozzo, and Anna Sofia Delussu. "Wheelchair Propulsion Biomechanics in Junior Basketball Players: A Method for the Evaluation of the Efficacy of a Specific Training Program." BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/275965.

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As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i) proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii) developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.1 ± 2.7 years, years of practice = 4.5 ± 1.8) equipped with wheelchair- and wrist-mounted inertial sensors performed a 20-metre sprint test. Biomechanical parameters related to propulsion timing, progression force, and coordination were estimated from the measured accelerations and used in a regression model where the time to complete the test was set as dependent variable. Force- and coordination-related parameters accounted for 80% of the dependent variable variance. Based on these results, a training program was designed and administered for three months to six of the athletes (the others acting as control group). The biomechanical indicators proved to be effective in providing additional information about the wheelchair propulsion technique with respect to the final test outcome and demonstrated the efficacy of the developed program.

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Neto, Frederico Ribeiro, Rodrigo R. Gomes Costa, Jefferson R. Dorneles, Carlos W. Gonçalves, João H. C. L. Veloso, and Rodrigo L. Carregaro. "Handgrip Strength Cutoff Points for Functional Independence and Wheelchair Ability in Men With Spinal Cord Injury." Topics in Spinal Cord Injury Rehabilitation 27, no. 3 (August 13, 2021): 60–69. http://dx.doi.org/10.46292/sci20-00040.

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Objectives: To determine optimal handgrip strength (HGS) cutoff points for greater functional independence and wheelchair skills in men with spinal cord injury (SCI), and to establish predictive equations for functional independence and wheelchair ability in men with SCI, based on demographic characteristics, HGS, and functionality. Methods: In this cross-sectional study conducted at a rehabilitation hospital, 54 men with SCI were recruited and stratified into high and low paraplegia groups. All participants performed a maximum HGS test to determine cutoff points for the Spinal Cord Independence Measure (SCIM-III) and Adapted Manual Wheelchair Circuit (AMWC). The primary outcomes were the SCIM-III, AMWC, and HGS. Demographic characteristics obtained from participants’ electronic medical records were the secondary outcomes, used as predictor variables of functional independence. Results: The SCIM-III scale, performance score, and 3-minute overground wheeling test presented significant regression equations (R = 0.45, R = 0.69, and R = 0.72). The HGS showed a cutoff point of 102.5 kilogram force (kgf) to achieve a score of 70 on the SCIM-III and a 3-minute overground wheeling distance of 270 m. The HGS cutoff point to obtain a performance score of 23.7 seconds was 93.0 kgf. Conclusion: The HGS was a significant predictor for the SCIM-III score, AMWC performance score, and 3-minute overground wheeling test. Three significant predictive equations were established based on HGS. The cutoff points could be adopted as parameters for optimal functional independence and wheelchair skills.

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Farì, Giacomo, Marisa Megna, Pietro Fiore, Maurizio Ranieri, Riccardo Marvulli, Valerio Bonavolontà, Francesco Paolo Bianchi, Filomena Puntillo, Giustino Varrassi, and Victor Machado Reis. "Real-Time Muscle Activity and Joint Range of Motion Monitor to Improve Shoulder Pain Rehabilitation in Wheelchair Basketball Players: A Non-Randomized Clinical Study." Clinics and Practice 12, no. 6 (December 16, 2022): 1092–101. http://dx.doi.org/10.3390/clinpract12060111.

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Wheelchair basketball (WB) involves sports gestures that expose the shoulder to high biomechanical stress and frequently lead to shoulder pain (SP). Due to their physical peculiarities and sporting performance, these athletes require specific rehabilitation programs that are as fast, personalized and effective as possible. However, there are few studies specifically dedicated to these purposes. Surface electromyography (sEMG) seems a promising tool for better customization and achieving more targeted rehabilitation results. The aim of this study was to evaluate the usefulness of sEMG to monitor SP rehabilitation outcomes in WB players. Thirty-three athletes were enrolled in this non-randomized clinical study and divided into two groups. Both groups underwent a shoulder rehabilitation protocol, but only the experimental group was monitored in real time with sEMG on the shoulders. At enrollment (T0), at the end of 4 weeks of the rehabilitation program (T1), and 8 weeks after T1 (T2), the following outcome measures were collected: Wheelchair User’s Shoulder Pain Index (WUSPI), 20 m straight line test, shoulder abduction range of motion (ROM). There was a statistically significant difference for WUSPI and ROM scores in the comparison between groups (p < 0.001), and for all outcomes in the comparison between times and in the interaction between time and group (p < 0.001). Therefore, the experimental group showed a better improvement at all detection times compared to the control group. sEMG seems a useful tool for improving the monitoring of SP rehabilitation outcomes in WB players. This monitoring speeds up and improves the rehabilitative results, limiting the risk of sport abandonment and increasing the possibility for people with disabilities to quickly return to practice physical activity.

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Farì, Giacomo, Marisa Megna, Maurizio Ranieri, Francesco Agostini, Vincenzo Ricci, Francesco Paolo Bianchi, Ludovica Rizzo, et al. "Could the Improvement of Supraspinatus Muscle Activity Speed up Shoulder Pain Rehabilitation Outcomes in Wheelchair Basketball Players?" International Journal of Environmental Research and Public Health 20, no. 1 (December 24, 2022): 255. http://dx.doi.org/10.3390/ijerph20010255.

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Shoulder pain (SP) is a common clinical complaint among wheelchair basketball (WB) players, since their shoulders are exposed to intense overload and overhead movements. The supraspinatus tendon is the most exposed to WB-related injuries and it is primarily responsible for SP in WB athletes. In these cases, SP rehabilitation remains the main treatment, but there is still a lack of specific protocols which should be customized to WB players’ peculiarities and to the supraspinatus muscle activity monitor, and the improvement of rehabilitation outcomes is slow. Thus, the aim of this study was to verify if the improvement of supraspinatus muscle activity, monitored in real time with surface electromyography (sEMG) during the execution of therapeutic exercises, could speed up SP rehabilitation outcomes in WB players. Thirty-three athletes were enrolled. They were divided into two groups. Both groups underwent the same shoulder rehabilitation program, but only the Exercise Plus sEMG Biofeedback Group executed therapeutic exercises while the activity of the supraspinatus muscles was monitored using sEMG. Participants were evaluated at enrollment (T0), at the end of 4 weeks of the rehabilitation program (T1), and 8 weeks after T1 (T2), using the following outcome measures: supraspinatus muscle activity as root mean square (RMS), Wheelchair User’s Shoulder Pain Index (WUSPI), shoulder abduction, and external rotation range of motion (ROM). The Exercise Plus sEMG Biofeedback Group improved more and faster for all the outcomes compared to the Exercise Group. The monitoring and improvement of supraspinatus muscle activity seems to be an effective way to speed up SP rehabilitation outcomes in WB players, since it makes the performance of therapeutic exercise more precise and finalized, obtaining better and faster results in terms of recovery of shoulder function.

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Silveira, Stephanie L., Brenda Jeng, Gary Cutter, and Robert W. Motl. "Perceptions of physical activity guidelines among wheelchair users with multiple sclerosis." Multiple Sclerosis Journal - Experimental, Translational and Clinical 8, no. 2 (April 2022): 205521732210975. http://dx.doi.org/10.1177/20552173221097580.

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Background Physical activity guidelines provide prescriptive resources for population-level promotion of behavior change to improve health outcomes. The National Multiple Sclerosis Society (NMSS) recently created and disseminated physical activity guidelines for persons with multiple sclerosis (MS) across the disease spectrum. Objective This study aimed to assess perceptions of the updated NMSS Physical Activity Guidelines among wheelchair users with MS. Methods One hundred thirty-four wheelchair users with MS participated in a cross-sectional study examining health behaviors. Outcomes were measured using an online questionnaire that included items related to demographic and clinical characteristics and a battery of questions regarding perceptions of the NMSS Physical Activity Guidelines based on Expanded Disability Status Scale groups 7.0–7.5 & 8.0–8.5. Results Among the 134 participants, 77 participants (58%) did not meet the general recommendations, 43 participants sometimes meet the general recommendations (32%), and 14 participants (10%) reported meeting the general recommendations. Participants reported positive perceptions across modalities (i.e. Breathing, Flexibility, Upper Extremity, Lower Extremity, and Core Exercises); however Upper and Lower Extremity Exercises were rated as the most challenging based on inability to complete independently. Conclusion Wheelchair users with MS in this study generally rated the NMSS Guidelines for Physical Activity as appropriate.

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Grossmann, Fabian, Joelle Leonie Flueck, Bart Roelands, Romain Meeusen, and Claudio Perret. "Validity of a Wheelchair Rugby Field Test to Simulate Physiological and Thermoregulatory Match Outcomes." Sports 10, no. 10 (September 23, 2022): 144. http://dx.doi.org/10.3390/sports10100144.

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The purpose of the study was to verify the criterion-validity (concurrent) of an existing and reliable, submaximal wheelchair Rugby (WCR) field test by examining the correlations of selected measures of physical performance between the field test and real games. Therefore, ten WCR athletes were observed during two WCR real games and during completing the field test two times. Total distance, mean and peak velocity, playing time, number of sprints, sprints per minute, mean and maximal heart rate, body core temperature (Tc), sweat rate, body weight loss, rate of perceived exertion and thermal sensation were measured. Values were correlated with the data observed by completing the field test two times separated by seven days. The results showed significant correlations between games and field tests for sweat rate (r = 0.740, p < 0.001), body weight loss (r = 0.732, p < 0.001) and the increase of Tc (r = 0.611, p = 0.009). All other correlations were not significant. For perceptual responses Bland–Altman analysis showed data within the limits of agreement. Descriptive statistics showed similarity for mean velocity and total distance between tests and games. In conclusion the study provides the first indications that the submaximal field test seems comparable with the game outcomes in terms of increase in Tc, covered distance, mean velocity and perceptual responses. Nevertheless, more research and additional validation are required.

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Sanz Quinto, Santiago, Olivier Girard, Raúl López Grueso, Gabriel Brizuela, and Manuel Moya Ramón. "Hematological and Ventilatory Responses to a 3900 M Altitude Sojourn in an Elite Wheelchair-marathoner." European Journal of Sport Sciences 1, no. 1 (February 16, 2022): 1–8. http://dx.doi.org/10.24018/ejsport.2022.1.1.2.

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This case study aimed to report blood markers and resting respiratory rate (RR) oscillations at sea level, during a 5-wk 3900 m altitude sojourn, and after returning to sea level in a 36-year-old professional wheelchair marathoner. Outcome measures plasma erythropoietin (EPO) concentration, hemoglobin, reticulocytes count, erythrocytes and hematocrit as well as RR were measured upon wakening 7-weeks pre-altitude, 7-days pre-altitude, 35 hours after arrival to altitude, on days 8, 15, 21, 28 and 35 at altitude, 6 and 16 days after returning to sea level. EPO increased up to 259 % (31.6 U l-1) 35 hours upon arrival at altitude and decreased below pre-altitude level (12.2 U l-1) on the 21st day of the camp (8.7 U l-1), reaching the lowest values 16 days after returning from altitude (1.9 U l-1). All blood parameters, except for reticulocytes, increased (range: +17.9 to +23.8%) after 35 days of altitude exposure. Compared to pre-altitude, RR increased during the first week of exposure to hypoxic conditions and remained elevated throughout the camp until the fifth week (5.1±0.4 vs. 9.1±1.6 and 6.6±0.8 breaths min-1; Cohen´s d = +3.4 and +2.4, respectively). A 5-wk high-altitude sojourn triggered polycythemia and elevations in RR (as indicators of effective hypoxic acclimatization) in a professional wheelchair-marathoner.

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Susanto,, Ratno, and Achmad Afandi. "Peningkatan Senam Lantai Meroda Dengan Model Cooperative Learning Tipe Circuit Learning." Jurnal Porkes 4, no. 2 (December 31, 2021): 204–9. http://dx.doi.org/10.29408/porkes.v4i2.5047.

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This exploration aims to improve wheelchair gymnastics through cooperative learning type circuit learning for Madrasah Tsanawiyah Nurul Huda Dau due to the lack of interest of students who participate in wheelchair gymnastics and require many learning models to attract students' interest in exercising. The learning process that requires time for achievement to achieve the KKM value of exploration needs to be carried out and developed to achieve the learning outcomes obtained with their abilities. This exploration is Classroom Action Research (CAR). Do-it-yourself exploration with 25 students. The exploration uses observation, cycle I, cycle II, action implementation, and reflection. Exploration instruments that are used during exploration are the rubric for assessing the wheeling motion (KI 3: Psychomotor) and sheets (KI 4: Cognitive). Exploratory data analysis techniques measure plus achieve learning outcomes and use quantitative data analysis. The results of exploration in learning 10 students completed 15 students did not complete learning. Students are given a circuit learning type of cooperative learning media as a means of moving learning outcomes, usually, from 25 students, 80% of learning outcomes are obtained. The conclusion is that exploration in cycle II shows an escalation of the learning effect of 25 students as much as 74%.

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Kooijmans, Hedwig, Marcel W. M. Post, Henk J. Stam, Lucas H. V. van der Woude, Dorien C. M. Spijkerman, Govert J. Snoek, Helma M. H. Bongers-Janssen, C. F. van Koppenhagen, Jos W. Twisk, and Johannes B. J. Bussmann. "Effectiveness of a Self-Management Intervention to Promote an Active Lifestyle in Persons With Long-Term Spinal Cord Injury: The HABITS Randomized Clinical Trial." Neurorehabilitation and Neural Repair 31, no. 12 (December 2017): 991–1004. http://dx.doi.org/10.1177/1545968317736819.

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Background. Most people with long-term spinal cord injury (SCI) have a very inactive lifestyle. Higher activity levels have been associated with health benefits and enhanced quality of life. Consequently, encouraging an active lifestyle is important and behavioral interventions are needed to establish durable lifestyle changes. Objective. The Healthy Active Behavioral Intervention in SCI (HABITS) study was aimed to evaluate the effectiveness of a structured self-management intervention to promote an active lifestyle in inactive persons with long-term SCI. Methods. This assessor-blinded randomized controlled trial was conducted at 4 specialized SCI units in the Netherlands. Sixty-four individuals with long-term SCI (>10 years), wheelchair-user and physically inactive, were included. Participants were randomized to either a 16-week self-management intervention consisting of group meetings and individual counseling and a book, or to a control group that only received information about active lifestyle by one group meeting and a book. Measurements were performed at baseline, 16 weeks, and 42 weeks. Primary outcome measures were self-reported physical activity and minutes per day spent in wheelchair driving. Secondary outcomes included perceived behavioral control (exercise self-efficacy, proactive coping), stages of change concerning exercise, and attitude toward exercise. Results. Mixed models analyses adjusted for age, sex, level of SCI, time since injury, baseline body mass index, and location did not show significant differences between the intervention and control groups on the primary and secondary outcomes ( P ≥ .05). Conclusions. A structured 16-week self-management intervention was not effective to change behavior toward a more active lifestyle and to improve perceived behavioral control, stages of change, and attitude.

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Shackleton, Claire, Soshi Samejima, Tiev Miller, Ali Hosseinzadeh, Amanda H. X. Lee, Rahul Sachdeva, Tom E. Nightingale, and Andrei V. Krassioukov. "May I Have This Dance: A Case-Series on the Acute Cardiometabolic Demand of Wheelchair Dancing in Recreational Dancers with Spinal Cord Injury." Medical Problems of Performing Artists 37, no. 4 (December 1, 2022): 269–77. http://dx.doi.org/10.21091/mppa.2022.4035.

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OBJECTIVES: This case-series investigated energy expenditure, cardiovascular responses, and psychosocial outcomes during two wheelchair dancing routines with different tempos. METHODS: Three individuals with chronic, non-traumatic spinal cord injuries [males, mean age 42 (13) years, C3-T12, AIS D, schwannoma=1, poliomyelitis=1, ependymoma=1] performed slow (rumba, 80 bpm) and fast (salsa, 170 bpm) wheelchair dance routines. Physiological [heart rate, blood pressure, relative oxygen consumption (VO2), metabolic task equivalent] and psychosocial parameters [ratings of perceived exertion, enjoyment and Brunel Mood Score] were measured pre, during, and post-dancing. RESULTS: All participants showed an elevation in heart rate and relative VO2 from rest to dancing with a subsequent decrease in these parameters post-dance for both routines. Relative to the slow dance routine, two out of three participants demonstrated greater heart rate, relative VO2, ratings of perceived exertion, and enjoyment during the fast dance routine. For all three participants, metabolic task equivalents ranged from 1.7–2.4 (slow) and 2.1–3.8 (fast), suggesting the intervention was of light to moderate intensity for slow and fast dance routines, respectively. Enjoyment ratings ranged from “quite a bit” to “extremely.” No differences in Brunel mood subscales were observed. CONCLUSION: This case-series offers a preliminary understanding of the acute cardiometabolic and psychosocial responses to wheelchair dance routines of differing intensities performed by individuals with spinal cord injury. Responsiveness observed among these participants suggests the potential use of wheelchair dance for promoting physical activity and improving psychological well-being.

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Jayaraman, Arun, Sean Deeny, Yochai Eisenberg, Gayatri Mathur, and Todd Kuiken. "Global Position Sensing and Step Activity as Outcome Measures of Community Mobility and Social Interaction for an Individual With a Transfemoral Amputation Due to Dysvascular Disease." Physical Therapy 94, no. 3 (March 1, 2014): 401–10. http://dx.doi.org/10.2522/ptj.20120527.

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Background and Purpose Community mobility of individuals following lower limb amputation is highly variable and has a great impact on their quality of life. Currently, clinical assessments of ambulatory ability and motivation influence prosthetic prescription. However, these outcome measures do not effectively quantify community mobility (ie, mobility outside of the clinic) of individuals with an amputation. Advances in global positioning systems (GPSs) and other wearable step-monitoring devices allow for objective, quantifiable measurement of community mobility. This case report will examine the combined use of a GPS unit and a step activity monitor to quantify community mobility and social interaction of an individual with transfemoral amputation due to dysvascular disease. Case Description A 76-year-old woman with a unilateral transfemoral amputation due to vascular disease carried a commercial GPS unit and step activity monitor to quantify her community mobility and social interaction every day over a period of 1 month. The step activity monitor was affixed to her prosthesis. The patient used a wheelchair as well as her prosthesis for everyday mobility. Outcome Information from the GPS unit and step activity monitor provided quantitative details on the patient's steps taken in and out of the home, wheelchair use, prosthesis use, driving trips, and time spent on social and community trips. Discussion This case report describes a potential clinical measurement procedure for quantifying community mobility and social interaction of an individual with lower limb amputation. Future efforts are needed to validate this measurement tool on large sample sizes and in individuals with different mobility levels. Additionally, automatization of data analysis and technological approaches to reduce compromised GPS signals may eventually lead to a practical, clinically useful tool.

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Giesbrecht, Ed, Julie Faieta, Krista Best, François Routhier, William C. Miller, and Maude Laberge. "Impact of the TEAM Wheels eHealth manual wheelchair training program: Study protocol for a randomized controlled trial." PLOS ONE 16, no. 10 (October 13, 2021): e0258509. http://dx.doi.org/10.1371/journal.pone.0258509.

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Background Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform. Objective This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group. Setting The study will be implemented in a community setting in three Canadian cities. Participants Individuals ≥ 18 years of age within one year of transitioning to use of a MWC. Intervention Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75–150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants’ training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection. Measurements Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group. Impact statement We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control group.

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Gómez-Valero, Sara, Fernando García-Pérez, Mariano Tomás Flórez-García, and Juan Carlos Miangolarra-Page. "Assessment of cross-cultural adaptations of patient-reported shoulder outcome measures in Spanish: a systematic review." Shoulder & Elbow 9, no. 4 (February 17, 2017): 233–46. http://dx.doi.org/10.1177/1758573217694340.

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Background The present study aimed to conduct a systematic review of self-administered shoulder-disability functional assessment questionnaires adapted to Spanish, analyzing the quality of the transcultural adaptation and the clinimetric properties of the new version. Methods A search of the main biomedical databases was conducted to locate Spanish shoulder function assessment scales. The authors reviewed the papers and considered whether the process of adaptation of the questionnaire had followed international recommendations, and whether its psychometric properties had been appropriately assessed. Results The search identified nine shoulder function assessment scales adapted to Spanish: Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Upper Limb Functional Index (ULFI), Simple Shoulder Test (SST), Shoulder Pain and Disability Index (SPADI), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), Western Ontario Rotator Cuff index (WORC), Western Ontario Shoulder Instability index (WOSI) and Wheelchair Users Shoulder Pain Index (WUSPI). The DASH was adapted on three occasions and the SPADI on two. The transcultural adaptation procedure was generally satisfactory, albeit somewhat less rigorous for the SDQ and WUSPI. Reliability was analyzed in all cases. Validity was not measured for one of the adaptations of the DASH, nor was it measured for the SDQ. Conclusions The transcultural adaptation was satisfactory and the psychometric properties analyzed were similar to both the original version and other versions adapted to other languages.

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Journal articles on the topic 'Wheelchair outcome measure'

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