Wheelchair technology & spinal cord injury



The current issue of the Journal of Rehabilitation Research and Development (JRRD) is dedicated to spinal cord injury and wheelchair technology. Full-text articles are available, free, online at http://www.vard.org.



Excess weight, push technique contribute to upper limb injury in users of manual wheelchairs

This study makes recommendations for wheelchair propulsion and setup that may reduce the risk of developing shoulder and wrist injuries. Over 60 manual wheelchair users with paraplegia propelled their manual wheelchair on a stationary roller system at self-selected, slow, and moderately fast speeds. Participants also underwent extensive medical tests to evaluate upper-limb repetitive strain injuries. Investigators recommend using smooth, long strokes and letting the hand drift below the pushrim when not in contact with the wheel. They warn that weight gain can increase injury risk and suggest using a light-weight wheelchair with a forward-adjusted rear axle to ease propulsion and lessen stress on the upper limbs.

Rehabilitation improves wheelchair propulsion capacity in persons with spinal cord injury

This study describes the effect of rehabilitation to increase the ability of persons with spinal cord injury (SCI) to push a wheelchair. One hundred and thirty-two persons with SCI were tested three times during rehabilitation. Overall, wheelchair propulsion ability increased from the start of rehabilitation to the end of clinical rehabilitation. Men, younger persons, persons with paraplegia, and persons with incomplete lesions had greater ability to push a wheelchair. Older persons and women were found to have a lower rate of improvement. Persons with tetraplegia and paraplegia showed the same amount of improvement.

People with spinal cord injury report lower quality of life

This study reviews literature on the quality of life (QOL) of individuals with spinal cord injury (SCI) and discusses the validity of some QOL measurement tools. Three types of definitions of QOL are used in health services and medical and rehabilitation research. Published research indicates that people with SCI tend to indicate that their achievements and statuses are lower than those of their peers. Furthermore, they reported their well-being as having less value, and others consider their health status as less desirable. Investigators note that problems exist with some of the measurement instruments, and in certain instances, their use with a SCI group has not been justified.

Literature review indicates best practices following spinal cord injury

This study reviews select recovery outcomes and measures from multicenter studies and a large spinal cord injury (SCI) database to show that future SCI treatment strategies should be based on demonstrated effective interventions. Investigators found that an accurate examination in the first days following injury is critical to neurological recovery. Neurological recovery following SCI is often associated with an increase in function, walking, and self care. The Walking Index for Spinal Cord Injury has recently demonstrated validity and an increased sensitivity and responsiveness to change in neurological/walking function in patients with SCI.

Functional electrical stimulation reverses muscle degeneration

This study investigates muscle recovery induced by a new system of life-long functional electrical stimulation training in permanent denervated human muscle. Needle biopsies of long-term denervated muscles showed severe dystrophy beginning two years after spinal cord injury. The excitability of denervated muscles was first improved by twitch-contraction training. Then, stimulation against a progressively increased load was performed. Muscle biopsies show that this progressive training almost reversed long-term muscle atrophy/dystrophy.

Manual wheelchair skill influences social participation This study describes the relationship between manual wheelchair skill and social participation in persons with spinal cord injury (SCI) one year after injury. Eighty-one persons with SCI in the Netherlands performed a wheelchair- skills test. Social participation was moderately related to the number of wheelchair tasks that a person could perform and to the amount of time and physical strain required to perform these tasks, with the strongest association for performance time. Investigators conclude that wheelchair-skills training must be a top rehabilitation goal and that maintenance of those skills following discharge from rehabilitation should be encouraged.

http://www.eurekalert.org/pub_releas...s-wt091605.php