KINEMATICS OF WHEELCHAIR PROPULSION IN ADULTS AND CHILDREN WITH SPINAL-CORD INJURY

This study examined the kinematic features of wheelchair propulsion in two neurologically matched groups of adults and children with uncompl icated spinal cord injury. The average mass and age of the pediatric g roup was much smaller than the adult group (37.4kg and 11.3 years vs 6 8.5kg and 33.5 years). Each subject propelled his/her own chairs and n ew, low-mass wheelchairs at a steady, nominal speed of 2 m/sec across a level surface. Three dimensional video analysis determined the movem ent of upper body angles (elbow, shoulder, trunk, and shoulder abducti on) based on reflective markers placed on the subjects' shoulder, elbo w, wrist, and hip joints. Analysis of the temporal factors showed that although the average group overground velocities of the adult group ( 2.4m/sec) were significantly greater than the pediatric group (2.3m/se c), the two groups spent comparable proportions of the wheeling cycle in propulsion (24%). Analysis of the angular kinematics (elbow, should er, and shoulder abduction angular changes over a time normalized whee ling cycle) showed that whereas the pediatric group did show significa nt absolute angular differences from the adult group, the angular chan ges over time were the same in both groups. The implications of this w ork are that, for the first time, it can be said that children propel their wheelchairs in the same manner as adults. In addition, these dat a were similar to those previously reported in athletic adult populati ons. We conclude that published data from adult wheelchair users may b e applied to pediatric wheelchair users, thus providing a basis for pe diatric wheelchair prescription. Further studies using kinetic measure ments over longer time periods may be necessary to elucidate other pot ential similarities between the adult and pediatric wheeling style.