Physical Fitness Parameters of Elite Chinese Wheelchair Curlers / Parámetros de Aptitud Física de Curlers en Silla de Ruedas Chinos de Élite

SUMMARY: Few international studies have analyzed the characteristics of elite wheelchair curlers competing on the international stage. This study aims to investigate the physical fitness parameters of elite Chinese wheelchair curlers and explore the corresponding training enlightenment. Sixteen wheelchair curlers from the Chinese national team, including six male and two female Winter Paralympic gold medalists, were selected as research participants. The following parameters were measured: age, training age, height, weight, body fat percentage, grip strength, absolute bench press strength, and 5-km wheelchair push-timing test. Compared with ordinary curlers of the Chinese wheelchair curling team, elite curlers were older in age and training age; male curlers were shorter, whereas female curlers were taller. However, their weight and body fat percentage were lower, and their grip strength, absolute strength in the bench press, and 5-k wheelchair push-timing test were better. From an athlete development and physical training perspective, wheelchair curlers should increase training years in order to accumulate competition experience. Additionally, these athletes should manage their body weight and fat percentage, and improve their upper limb strength and aerobic capacity.

Pocos estudios internacionales han analizado las características de los curlers en silla de ruedas de élite que compiten en el escenario internacional. Este estudio tiene como objetivo investigar los parámetros de aptitud física de los bigudíes chinos en silla de ruedas de élite y explorar la iluminación del entrenamiento correspondiente. Se seleccionaron como participantes de la investigación dieciséis curlers en silla de ruedas del equipo nacional chino, incluidos seis medallistas de oro masculinos y dos femeninos de los Juegos Paralímpicos de Invierno. Se midieron los siguientes parámetros: edad, edad de entrenamiento, altura, peso, porcentaje de grasa corporal, fuerza de agarre, fuerza absoluta en press de banca y prueba de sincronización de empuje en silla de ruedas de 5 km. En comparación con los curlers ordinarios del equipo chino de curling en silla de ruedas, los curlers de élite eran mayores en edad y tiempo de entrenamiento; Los curlers masculinos eran más bajos, mientras que las mujeres eran más altas. Sin embargo, su peso y porcentaje de grasa corporal fueron menores, y su fuerza de agarre, fuerza absoluta en press de banca y prueba de sincronización de empuje en silla de ruedas de 5-k fueron mejores. Desde la perspectiva del desarrollo del atleta y del entrenamiento físico, los curlers en silla de ruedas deberían aumentar los años de entrenamiento para acumular experiencia en competencia. Además, estos deportistas deben controlar su peso corporal y porcentaje de grasa, y mejorar la fuerza de sus miembros superiores y su capacidad aeróbica.

Pressure pain threshold in people with amputation submitted to the use of postural lifting equipment: crossover experimental study / Limiar de dor por pressão em pessoas com amputação submetidas ao uso de equipamento de elevação postural: um estudo experimental cruzado

ABSTRACT BACKGROUND AND OBJECTIVES: Amputation is an event that has consequences that can affect daily life, including pain, enhancing changes, whether in sleep or in quality of life. The objective of this study was to evaluate the pressure pain threshold (PPT) in people with amputations submitted to the use of different postural elevation equipment. METHODS: Experimental crossover study, carried out from September to October 2022, with people with lower limb amputation (n=15) and people without amputation (n=15). PPT in four regions (T12-L1, L5-S1, anterior tuberosity of the tibia and calcaneus) were evaluated before and after the use of different versions (A and B) of an equipment for postural elevation, gravity and pain interference. Presence of signs and symptoms of central sensitization (CS) and sleep quality. RESULTS: The groups did not present PPT alterations when compared between the different versions of the equipment (p<0.05) in the four locations analyzed. Furthermore, the groups did not show differences in relation to the evaluation days or among themselves regarding the severity and interference of pain and the presence of signs and symptoms of CS. The control group indicated poor sleep quality (p=0.0173) and remained worse than people with amputation. CONCLUSION: The versions of the equipment did not change PPT in the analyzed areas. The groups did not differ between themselves, suggesting that the equipment promoted similar responses, that is, no change in sensitivity was evidenced in the analyzed regions which have greater contact with stabilization elements and weight discharge of the equipment.

RESUMO JUSTIFICATIVA E OBJETIVOS: A amputação é um evento que acarreta consequências que podem afetar o cotidiano, entre elas a dor, potencializando alterações, seja no sono ou na qualidade de vida. O objetivo deste estudo foi avaliar o limiar de dor por pressão (LDP) em pessoas com amputação submetidas ao uso de diferentes equipamentos de elevação postural. MÉTODOS: Estudo experimental cruzado, realizado de setembro a outubro de 2022, com pessoas com amputação no membro inferior (n=15) e pessoas sem amputação (n=15). Foram avaliados o LDP em quatro regiões (T12-L1, L5-S1, tuberosidade anterior da tíbia e calcâneo) pré e pós uso de distintas versões (A e B) de um equipamento de elevação postural, gravidade e interferência da dor. Presença de sinais e sintomas de sensibilização central (SC) e qualidade do sono. RESULTADOS: Os grupos não apresentaram alterações no LDP quando comparados em relação às diferentes versões do equipamento (p<0,05) nos quatro locais analisados. Além disso, os grupos não mostraram diferenças em relação aos dias de avaliação ou entre si quanto a severidade e interferência de dor e presença de sinais e sintomas de SC. O grupo controle indicou uma qualidade de sono ruim (p=0,0173) e manteve-se pior que as pessoas com amputação. CONCLUSÃO: As versões do equipamento não alteraram o LDP nas áreas analisadas. Os grupos não apresentaram diferença entre si, sugerindo que o equipamento promoveu respostas semelhantes, ou seja, não foi evidenciada uma alteração de sensibilidade nas regiões que possuem maior contato com elementos de estabilização e descarga de peso dos equipamentos.

Optimization and simulation of maneuverability and stability of electric wheelchair based on three degrees of freedom model / 中国康复理论与实践

ObjectiveTo propose a three-degree-of-freedom model of electric wheelchair, to optimize the steering stability of the wheelchair. MethodsBased on the two degrees of freedom vehicle model and considering the influence of body inertia and lateral wind, the wheelchair roll angle was introduced to establish the three degrees of freedom steering model of wheelchair. The lateral velocity, centroid sideslip angle, yaw rate and body roll angle response of the motor angular velocity input under different working conditions were simulated and analyzed respectively. Taking KS2 electric wheelchair as an example, the wheelchair steering experiment was designed to verify the rationality and feasibility of the model, and the optimization effect of the model algorithm on the wheelchair handling and stability. ResultsThe maneuverability and stability of the electric wheelchair with three degrees of freedom model algorithm were significantly improved, and the response curve was smoother. The smaller the |VL-VR|/t was, the better the handling stability was when the left and right motors of the wheelchair had the same steering direction. When |VL-VR|/t was the same, the steering maneuverability was better on the reverse rotation of the motor, but the handling stability also decreased. ConclusionThe simulation analysis is in good agreement with the experimental results, which verifies that the model is reasonable and feasible. The model algorithm can better optimize the handling stability of electric wheelchairs, and can be generally applied to study and analyze the handling stability of different wheelchairs when they turn.

Visual perception and its related factors of distance for Paralympic athletes with physical disabilities / 中国康复理论与实践

ObjectiveTo investigate the impact of posture and sports experience on distance perception in Paralympic athletes with lower limbs disabilities. MethodsFrom May to August, 2019, athletes were selected from the wheelchair racing team (n = 19) and the wheelchair fencing team (n = 16) in Shanghai, China. The athletes were tested the relative distance perception and absolute distance perception using the successive equal-appearing distance and blind walking tasks. ResultsThe interaction effects between sport and posture (F = 4.118, P < 0.05), sports events and distance judgment (F = 8.913, P < 0.01), and posture and distance judgment (F = 11.894, P < 0.01) were significant; while the main effects of sport (F = 7.467, P < 0.01) and posture (F = 11.918, P < 0.01) were significant; the relative distance judgment accuracy was better in the athletes of wheelchair fencing than in those of wheelchair racing, and in standing posture than those in sitting posture. ConclusionThe relative distance judgment accuracy is better for the Paralympic athletes standing and playing wheelchair fencers. There was no significant difference in the accuracy of absolute distance judgment between the different postures and the different sports.

Effects of beside wheelchair seating training on EICU acquired myasthenia in patients with acute respiratory distress syndrome and mechanical ventilation / 中国实用护理杂志

Objective:To explore the application of beside wheelchair seating training in patients with acute respiratory distress syndrome (ARDS) and mechanical ventilation, so as to provide the reference for the nursing of acquired myasthenia in EICU.Methods:A total of 66 ARDS patients with mechanical ventilation treated in Beijing Hospital from July 2017 to July 2019 were assigned to the experimental group and the control group according to the admission time, 33 cases in each group. Patients in the control group received routine nursing, while the experimental group implemented beside wheelchair seating training. The differences in muscle strength, self care ability, duration of mechanical ventilation, length of EICU stay as well as complications between the two groups were compared.Results:The incidence of EICU acquired myasthenia in the experimental group was 18.2% (6 cases), which was significantly lower than that in the control group 42.4% (14 cases), the difference was statistically significant ( χ2=4.59, P<0.05). Out of EICU, the Medical Research Council (MRC) scores and Modified Barthel Index (MBI) scores were (48.27 ± 5.11), (59.67 ± 7.33) points in the experimental group, which were significantly higher than those in the control group (44.88 ± 6.75), (54.06 ± 8.53) points, the differences were statistically significant ( t=2.30, 2.86, both P<0.05). The length of EICU stay and duration of mechanical ventilation were (8.24 ± 1.48) d, (7.15 ± 1.48) d, in the experimental group, which were significantly lower than those in the control group (9.85 ± 2.99) d, (8.24 ± 1.77) d, the differences were statistically significant ( t=2.77, 2.72, both P<0.05). The oxygenation index after 30 minutes of weaning was (296.64 ± 15.45) mmHg (1 mmHg=0.133 kPa), which was significantly higher than that in the control group (288.36 ± 16.75) mmHg, the difference was statistically significant ( t value was 2.09, P<0.05). Conclusions:The beside wheelchair seating training can effectively decrease the incidence of EICU acquired myasthenia as well as shorten the duration of mechanical ventilation and length stay in EICU of patients with ARDS. It is safe and effective, and has good clinical application value.

El tenis paralímpico ecuatoriano: un acercamiento al contexto histórico real de su evolución deportiva / O ténis paralímpico equatoriano: uma abordagem do contexto histórico real da sua evolução desportiva / The Ecuadorian Paralympic tennis: an approach to the real historical context of its sport evolution

RESUMEN El tenis paralímpico a nivel internacional ha tenido un desarrollo destacado en las últimas décadas, por lo que se han realizado muchos estudios etnográficos desde su creación. El objetivo de esta investigación es la recopilación histórica de datos informativos sobre el origen del tenis paralímpico en el Ecuador, con una descripción de los personajes que hicieron posible tales sucesos, las circunstancias y su influencia en el futuro del deporte. El estudio se enmarcó en el paradigma cualitativo, desde campo histórico complejo, aplicando el método etnográfico para estructurar la información teórica recopilada a través de las técnicas de la revisión documental, apoyadas con un instrumento de matriz de categorías y la entrevista con dos instrumentos de banco de preguntas. La primera aplicada a cinco personalidades del tenis paralímpico ecuatoriano entre dirigentes deportivos y entrenadores, abordando la dimensión histórica del tenis paralímpico ecuatoriano; la segunda, a cinco deportistas de élite del tenis en silla de ruedas con la dimensión anécdotas deportivas en el tenis paralímpico. A los datos, se les analizó a través de la herramienta tecnológica Atlas.ti, emergiendo hallazgos inéditos y relevantes, con un acercamiento al contexto histórico real. Este estudio creará una base estructural con la cual deportistas, entrenadores, dirigentes e investigadores deportivos comprenderán el proceso histórico y el desarrollo evolutivo que ha tenido este deporte, garantizando el sentido de pertinencia que, sumado a la fuerte carga de motivación y dificultades superadas, permitirá que se adquieran herramientas necesarias para su mejora personal y deportiva frente a sus discapacidades.

RESUMO O ténis paralímpico a nível internacional teve um desenvolvimento notável nas últimas décadas, pelo que muitos estudos etnográficos foram feitos desde a sua criação. O objetivo desta investigação foi a recolha histórica de dados informativos sobre a origem do ténis paralímpico no Equador, com uma descrição das personagens que tornaram possíveis tais acontecimentos, as circunstâncias e a sua influência sobre o futuro do desporto. O estudo foi enquadrado no paradigma qualitativo, a partir de um campo histórico complexo, aplicando o método etnográfico para estruturar a informação teórica recolhida através das técnicas de revisão documental, apoiada por um instrumento de matriz de categoria e a entrevista com dois instrumentos de banco de perguntas. A primeira aplicou-se a cinco personalidades do ténis paralímpico equatoriano entre dirigentes desportivos e treinadores, abordando a dimensão histórica do ténis paralímpico equatoriano; a segunda aplicou-se a cinco desportistas de elite do ténis em cadeira de rodas com a dimensão de anedotas desportivas no ténis paralímpico. Os dados foram analisados através da ferramenta tecnológica Atlas.ti, emergindo descobertas não publicadas e relevantes, com uma abordagem ao contexto histórico real. Este estudo irá criar uma base estrutural com a qual os desportistas, treinadores, gestores e investigadores desportivos compreenderão o processo histórico e o desenvolvimento evolutivo que este desporto tem tido, garantindo o sentido de pertença que, somado à forte carga de motivação e dificuldades superadas, permitirá a aquisição das ferramentas necessárias para a sua melhoria pessoal e desportiva face às suas deficiências.

ABSTRACT The Paralympic tennis at international level has had a remarkable development in the last decades, so many ethnographic studies have been made since its creation. The objective of this research is the historical collection of informative data about the origin of Paralympic tennis in Ecuador, with a description of the characters who made such events possible, the circumstances and their influence on the future of the sport. The study was framed in the qualitative paradigm, from a complex historical field, applying the ethnographic method to structure the theoretical information collected through the techniques of documentary review, supported by a category matrix instrument and the interview with two question bank instruments. The first one applied to five personalities of the Ecuadorian Paralympic tennis among sports leaders and coaches, approaching the historical dimension of the Ecuadorian Paralympic tennis; the second one applied to five elite sportsmen of wheelchair tennis with the dimension of sports anecdotes in the Paralympic tennis. The data was analyzed through the technological tool Atlas.ti, emerging unpublished and relevant findings, with an approach to the real historical context. This study will create a structural basis with which athletes, coaches, managers and sports researchers will understand the historical process and evolutionary development that this sport has had, ensuring a sense of relevance that, added to the strong motivation and difficulties overcome, will allow the acquisition of tools necessary for personal improvement and sports against their disabilities.

Clinical Advance in Pediatric Wheelchair (review) / 中国康复理论与实践

Objective:To systematically review the effectiveness of pediatric wheelchairs on the function of children with disabilities. Methods:Literatures about clinical application of pediatric wheelchairs were researched from the PubMed, Web of Science, Embase, Cochrane Library, EBSCO (CINAHL), CNKI, Wanfang Database and VIP Database, till February, 2021. The clinical application effectiveness of pediatric wheelchairs was extracted and analyzed by inductive approach. Results:A total of ten case studies, one randomized controlled study and one cohort study were included, and quality assessment showed low quality. There were different types of pediatric wheelchairs for all ages over twelve months and different disease types of children, mostly for cerebral palsy. The review showed that pediatric wheelchairs mainly improved the motor function of disabled children, promoted the development of cognitive functions, and improved activities and participation abilities. The wheelchairs could be individually adapted to manual wheelchairs, electric wheelchairs and smart wheelchairs, according to the individual conditions of the children, with additional postural support devices for adaptive transformation. Conclusion:Pediatric wheelchairs can be used to improve the function and quality of life of children with disabilities. Although functional rehabilitation effects of pediatric wheelchairs have shown a promising trend, most of the current studies are case reports, and there is a lack of high-quality clinical control studies, and the unified adaptation standard has not been established yet.

A Case of Cubital Tunnel Syndrome Due to Ulnar Nerve Dislocation Further Affected by Sitting Exercises Using an Over-table / The Japanese Journal of Rehabilitation Medicine

Herein, we report a case of a 49-year-old man with a history of bilateral hemiplegia caused by severe traumatic brain injury. During his stay in the convalescent rehabilitation hospital, he developed a flexion deformity of the 4th and 5th fingers of his right hand. Elbow palpation and ultrasonography showed that the ulnar nerve was dislocated from the elbow canal, and a nerve conduction study revealed that the conduction velocity was low in the right elbow. Thus, a diagnosis of cubital tunnel syndrome was made and an ulnar nerve transfer was performed to prevent progression. Prior to onset, an over-table had been used by the patient for daily activities such as sitting, training, and eating. Therefore, it was considered that the repeated use of the over-table plausibly exerted pressure on the dislocated ulnar nerve, leading to the onset of the cubital tunnel syndrome.As over-tables and wheelchair armrests are often used during rehabilitation, it is imperative to pay attention to elbow compression when using them in patients with ulnar nerve dislocation.

Impact of intrinsic motivation on competitive anxiety among wheelchair handball athletes / Impacto da motivação intrínseca sobre a ansiedade competitiva em atletas de handebol em cadeira de rodas

ABSTRACT Motivation and anxiety have been a recurrent theme in debates around sports, and understanding their relevance for competitive practice and their effects on athletes becomes imperative. This study aimed to investigate the impact of intrinsic motivation on the anxiety of Wheelchair Handball (WCH) athletes. The Intrinsic Motivation Inventory (IMI) and the Sport Anxiety Scale (SAS) were applied to 37 male athletes (34.18 ± 9.32 years old) with physical disabilities and participating in the Brazilian WCH championship. Data analysis was conducted by means of the Shapiro-Wilk, Pearson's Correlation and Multiple Linear Regression tests (p < 0.05). As a result, the intrinsic motivation subscales presented high scores both on the subscales that contribute positively (Pleasure/Interest, Competence, and Perceived exertion) and on the subscale that contributes negatively (Pressure/Tension). As for the impact of motivation on competitive anxiety, the athlete feeling competent inversely explained 15% of the variance of somatic anxiety. Competence presented a negative impact, and Pressure/Tension, a positive impact on the Concern subscale. Additionally, the Pleasure/Interest, Pressure/Tension and Perceived exertion subscales explained 31% of the variance of anxiety related to Disturbance of concentration, indicating that the greater the perception of pleasure with the practice and the greater the effort towards tasks, the less disturbance in concentration, and that the higher the pressure/tension score (lower perception of pressure), the greater the disturbance in the athlete's concentration. It was concluded that intrinsic motivation is a determining factor for controlling competitive anxiety in WCH athletes.

RESUMO A motivação e a ansiedade tem sido tema recorrente de debates no esporte e enteder sua relavância para a prática competitiva e os efeitos nos atletas se tornam imprescindível. Este estudo objetivou investigar o impacto da motivação intrínseca sobre a ansiedade de atletas de Handebol em Cadeira de Rodas (HCR). Foram aplicados o Inventário de Motivação Intrínseca (IMI) e a Escala de Ansiedade no Desporto (SAS) em 37 atletas (34.18 ± 9.32 anos), do sexo masculino, com deficiência fisica, participantes do campeonato Brasileiro de HCR. A análise dos dados foi conduzida por meio dos testes de Shapiro Wilk, a Correlação de Pearson e a Regressão Linear Múltipla (p < 0,05). Como resultado, as subescalas da motivação intrínseca apresentaram escores elevados tanto nas subescalas que contribuem de forma positiva (Prazer/Interesse, Competência e Percepção do esforço), quanto na subescala que contribui de forma negativa (Pressão/Tensão). Em relação ao impacto da motivação sobre a ansiedade competitiva, o atleta se sentir competente explicou inversamente 15% da variância da ansiedade somática. A competência apresentou impacto negativo e a Pressão/Tensão impacto positivo sobre a subescala de Preocupação. Ademais, as subescalas de Prazer/Interesse, Pressão/Tensão e Percepção do esforço explicaram 31% da variância da ansiedade relacionada à Perturbação da Concentração, indicando que que quanto maior a percepção de prazer pela prática e esforço perante as tarefas, menos perturbações na concentração, e quanto maior o escore de pressão/tensão (menor percepção de pressão), maior a perturbação da concentração do atleta. Concluiu-se que a motivação intrínseca é um fator determinante para o controle da ansiedade competitiva dos atletas de HCR.

Effect of training session on mood state responses in athletes of wheelchair basketball team / Efeito de sessões de treinamento nas respostas de estado de humor em atletas de uma equipe de basquete em cadeira de rodas

ABSTRACT The assessment of mood state can be used as a tool for monitoring the training adaptation. However, to athletes with a physical disability, this tool is still a few explored, especially in training daily conditions. The aim of the study was to analyze the mood state during training sessions in wheelchair basketball athletes. Twelve male athletes, aged between 23 and 62 years old, were evaluated. The subjects answered the POMS questionnaire before and after five training sessions during the preparatory period. Shapiro Wilk test for normality and Friedman were used for comparison amongst sessions, adopting p<0.05. It was found that the athletes presented a positive mood profile (iceberg) during the analyzed period. A negative mood reduction and positive mood maintenance were observed after all training sessions. Therefore, the results indicate that the training sessions can decrease the negative mood dimension, especially the depression and anger in wheelchair basketball athletes.

RESUMO A avaliação do estado de humor pode ser utilizada como uma ferramenta para monitorar as adaptações ao treinamento. Entretanto, para atletas com deficiência física, essa ferramenta ainda encontram-se pouco explorada, principalmente em condições do dia a dia de treinamento. O objetivo do estudo foi analisar o estado de humor durante sessões de treinamento em atletas de basquete em cadeira de rodas. Foram avaliados 12 atletas do sexo masculino, com idade entre 23 e 62 anos. Os sujeitos responderam o questionário POMS pré e pós cinco sessões de treinamento durante o período preparatório. Foram utilizados o teste de Shapiro Wilk para normalidade e Friedman para comparação do humor entre as sessões, adotando-se p<0,05. Verificou-se que os atletas apresentaram um perfil positivo (iceberg) de humor nas sessões analisadas. Uma redução do humor negativo e uma manutenção do humor positivo foi observada após todas as sessões de treinamento. Dessa maneira, os resultados indicam que sessões de treinamento esportivo podem diminuir as dimensões negativas do humor, principalmente a depressão e a raiva em atletas de uma equipe de basquete em cadeira de rodas.

Fatores relacionados à eficiência da propulsão em cadeira de rodas manual de usuários com paraplegia devido à lesão medular / Factors related to propulsion efficiency in manual wheelchair users with paraplegia due to spinal cord injury

Resumo Introdução Indivíduos com paraplegia devido à lesão medular (LM) realizam propulsão de cadeira de rodas manual (CRM), a fim de promover mobilidade funcional para realização das atividades cotidianas. No entanto, a ineficiência da propulsão causada pela inadequada configuração da CRM, assim como dores e lesões nos membros superiores (MMSS), pode resultar na diminuição da mobilidade do usuário. Objetivo Por meio da metodologia da revisão integrativa, buscou-se identificar e avaliar fatores relacionados à eficiência da propulsão em CRM de usuários com paraplegia devido à LM. Método Foram selecionados estudos indexados na PubMed, LILACS e SciELO sobre a biomecânica da propulsão de usuários de CRM com paraplegia devido à LM, entre os anos de 2008 e 2018. Resultados Dentre os 10 estudos incluídos na revisão, dois foram classificados como nível III-2 e oito como nível IV de evidência. Foram identificados como fatores relacionados à eficiência da propulsão: os momentos não propulsivos; a velocidade dos MMSS na fase de recuperação; a posição da mão no período de liberação; o tamanho do encosto; a manutenção do peso corporal; o nível de atividade diária e a força de adutores de ombro; a intensidade da propulsão; a orientação dos MMSS; e o tempo de LM. Conclusão As evidências sobre ciclo e padrões de propulsão, configurações de CRM, características do usuário e dores e lesões nos MMSS demonstraram ser fatores relacionados à eficiência da propulsão em CRM de usuários com paraplegia devido à LM.

Abstract Introduction Individuals with paraplegia due to spinal cord injury (SCI) perform manual wheelchair (MWC) propulsion to promote functional mobility to perform daily activities. However, the inefficiency of propulsion caused by inadequate MWC setting, as well as pain and upper limb injury (UL), can result in decreased user mobility. Objective Through the methodology of the integrative review, sought to identify and evaluate factors related to propulsion efficiency in MWC of users with paraplegia due to SCI. Method We selected indexed studies in PubMed, LILACS, and SciELO on the biomechanics of the propulsion of users with paraplegia due to SCI between 2008 and 2018. Results Among the 10 studies included in the review, two studies were classified as level III-2 and eight as level IV evidence. Factors related to propulsion efficiency were identified as: non-propulsive moments; the speed of the UL in the recovery phase; the position of the hand in the release period; the size of the backrest; maintaining body weight; the level of daily activity and shoulder adduction strength; the intensity of the propulsion; the orientation of the UL and the SCI time. Conclusion Evidence regarding the cycle and propulsion patterns, MWC settings, user characteristics, and pain and injury in the UL proved to be factors related to propulsion efficiency in MWC of users with SCI paraplegia.

Acessibilidade para usuários de cadeira de rodas em estabelecimentos comerciais: o caso de cidades turísticas da Serra Gaúcha / Accessibility for wheelchair users in commercial establishments: the case of tourist cities of Serra Gaúcha

O artigo visa analisar em que medida os estabelecimentos comerciais de duas cidades turísticas da Serra Gaúcha são acessíveis aos usuários de cadeira de rodas. A pesquisa é de natureza básica, de caráter descritivo e realizada sob o paradigma quantitativo e qualitativo. Foi realizado um estudo de caso em duas cidades da Serra Gaúcha, onde foram analisados 377 estabelecimentos comerciais. Os resultados indicaram que 38,45% dos estabelecimentos estudados oferecem rampas adequadas e somente 1,32% disponibilizam sanitários adaptados. Portas acessíveis foram identificadas em 80,36%, bem superior aos demais itens analisados, porém ainda insuficiente para garantir a acessibilidade universal. Pode-se inferir que se encontrou um número significativo de barreiras arquitetônicas que interferem negativamente na acessibilidade da população local e dos turistas usuários de cadeira de rodas.

The article aims to analyze in what extent the commercial establishments of two tourist cities of the Serra Gaúcha are accessible to wheelchair users. The research has a basic nature, a descriptive character and was performed under the quantitative and qualitative paradigm. The case study was carried out in two cities of the Serra Gaúcha, where 377 commercial establishments were analyzed. The results indicated that 38.45% of the establishments studied offer adequate ramps and only 1.32% offer adapted toilets. Accessible doors were identified at 80.36%, well above the other items analyzed, but still insufficient to guarantee universal accessibility. It can be inferred that a significant number of architectural barriers have been found that interfere negatively in the accessibility of the local population and the wheelchair users.

Indoor simulation training system for brain-controlled wheelchair based on steady-state visual evoked potentials / 生物医学工程学杂志

Brain-controlled wheelchair (BCW) is one of the important applications of brain-computer interface (BCI) technology. The present research shows that simulation control training is of great significance for the application of BCW. In order to improve the BCW control ability of users and promote the application of BCW under the condition of safety, this paper builds an indoor simulation training system based on the steady-state visual evoked potentials for BCW. The system includes visual stimulus paradigm design and implementation, electroencephalogram acquisition and processing, indoor simulation environment modeling, path planning, and simulation wheelchair control, etc. To test the performance of the system, a training experiment involving three kinds of indoor path-control tasks is designed and 10 subjects were recruited for the 5-day training experiment. By comparing the results before and after the training experiment, it was found that the average number of commands in Task 1, Task 2, and Task 3 decreased by 29.5%, 21.4%, and 25.4%, respectively ( < 0.001). And the average number of commands used by the subjects to complete all tasks decreased by 25.4% ( < 0.001). The experimental results show that the training of subjects through the indoor simulation training system built in this paper can improve their proficiency and efficiency of BCW control to a certain extent, which verifies the practicability of the system and provides an effective assistant method to promote the indoor application of BCW.

Design of Multimodality Wheelchair Based on Double Parallelogram Mechanism / 中国康复理论与实践

Objective:To design a multimodality wheelchair in order to meet many use requirements of the lower limbs dyskinesia patients. Methods:For some shortcomings of the existing multimodality wheelchair such as heavy structure and drive redundancy, the design of multimodality wheelchair based on double parallelogram mechanism is studied, and a simple and reliable multimodality wheelchair mechanism is presented. Rotary actuation drives the double parallelogram mechanism and makes parts of the wheelchair move, and three posture transformations are realized. The coupling movement of the back and leg rest realizes the transformation of sitting and supine posture, and the coupling movement of seat and back realizes the change of sitting and standing posture. The mechanical analysis of wheelchairs based on uniform load was carried out, and the rotation moment is calculated. Results:When the driving torque changed from sitting position to supine position, it increased with the increase of rotation angle and reached a peak value. When the driving torque changed from sitting position to standing position, it gradually decreased with the increase of rotation angle. Then the dynamics simulation is carried out in Adams software, the calculated results were basically consistent with the simulation results. Conclusion:The proposed mechanism is helpful to realize the lightweight design of multimodality wheelchair, and meets the design needs of intelligent multimodality wheelchair.

The Process Of Designing Special Wheel Chair For People With Physical Disabilities

@#There is a need to design and develop an affordable motorized vehicle for better mobility among physical disabilities. This study aimed is to initiate appropriate and affordable materials to develop an accessible motorized wheelchair. It includes the feasibility study of the existing used wheelchair, the system used and the characteristic of the physical disabilities symptom. Through the observation, an existing motorized wheelchair uses stainless steel as the main structure, manipulating the shelves heavy-duty accessories, electrical component, heavy-duty battery and car pulley system in which the weight accumulates approximately 100 kg. The heavyweight wheelchair cannot be folded and put inside the car. It also needs to have a special carrier to carry the wheelchair. The field research has also been conducted to evaluate the existing wheelchair system in the market with various systems used, components, and motors material used in the area of technical, usability and comfort before start to redesigning the wheelchair. The results of the study would include the background needs of the characteristic of physical disabilities. The available high-grade aluminium materials will be used to support the mobility and their relevant properties. The design will be done all the way and the specification will be used as an instrument data for the motorized vehicle. The selection of design features, documentation of design procedures and results will be used to create a P.O.C (Prove of Concept) prototype for the meant vehicle. The user will use the preliminary prototyping test and the data (result) will be used to improvise the wheelchair prototype. The second improvised prototype will undergo the second user testing in the area of reliability, stabilization of system, and ease of usage. The results expected will be observed and tested by the user to lead towards the recommendation of the motorized wheelchair design.

A Case of Cubital Tunnel Syndrome Due to Ulnar Nerve Dislocation Further Affected by Sitting Exercises Using an Over-table / The Japanese Journal of Rehabilitation Medicine

Herein, we report a case of a 49-year-old man with a history of bilateral hemiplegia caused by severe traumatic brain injury. During his stay in the convalescent rehabilitation hospital, he developed a flexion deformity of the 4th and 5th fingers of his right hand. Elbow palpation and ultrasonography showed that the ulnar nerve was dislocated from the elbow canal, and a nerve conduction study revealed that the conduction velocity was low in the right elbow. Thus, a diagnosis of cubital tunnel syndrome was made and an ulnar nerve transfer was performed to prevent progression. Prior to onset, an over-table had been used by the patient for daily activities such as sitting, training, and eating. Therefore, it was considered that the repeated use of the over-table plausibly exerted pressure on the dislocated ulnar nerve, leading to the onset of the cubital tunnel syndrome.As over-tables and wheelchair armrests are often used during rehabilitation, it is imperative to pay attention to elbow compression when using them in patients with ulnar nerve dislocation.

Propulsion efficiency in wheelchair tennis: a case study on the influence of the racket on the handrim forces

Aims: to evaluate how the act of holding a tennis racket influences the application of forces in the handrim during manual wheelchair propulsion at a self-selected comfortable speed and sprint. Methods: A case study was conducted with an experienced wheelchair tennis player who propelled the wheelchair in a straightforward trajectory at two different velocities (self-selected comfortable speed and sprint) in two different conditions (freehand and holding the racket). Kinetic and temporal data of the pushes were obtained with the SmartWheel system attached in substitution to the conventional rear wheel at the dominant side of the player. Results: holding the racket affects the propulsion pattern mainly when an accelerated movement is required (sprint). Compared to the propulsion at a self-selected speed, propelling the chair as fast as possible with the racket in hands resulted in lower total and tangential forces on the handrim, and decreased push time and increased push frequency. Conclusion: Such influence on both kinetic and temporal propulsion impact the mechanical efficiency of the manual wheelchair propulsion, which may, ultimately, affect the sport´s performance. Special attention should be directed to the propulsion training with the racket in maneuvers and motions that are characteristic of the wheelchair tennis match in an attempt to provide the athlete with proper technique for optimal propulsion efficiency and sports performance.(AU)

Cross-cultural adaptation and face validity of the Wheelchair Skills Test Questionnaire (Version 4.3) for caregivers / Adaptação transcultural e validade face do Wheelchair Skills Test Questionnaire (versão 4.3) para cuidadores

Abstract Introduction: In Brazil, there is a gap of assessment, encompassing the use of assistive technology and functional mobility of wheelchairs users and caregivers. The Wheelchair Skills Program (WSP) is an integrated system that includes elements for testing and training wheelchair users, clinicians and/or their caregivers. Objective: Cross-cultural adaptation of the Portuguese-Brazil version of the Wheelchair Skill Test Questionnaire (WST-Q Version 4.3), a component of the WSP, and to examine its face validity. Method: Interactive steps were applied to produce Portuguese-Brazil versions of the WST-Q. The Cultural, Idiomatic, Semantic and Conceptual Equivalences were evaluated by a Committee of Specialists. Fifteen informal caregivers were evaluated with the WST-Q Brazil. Results: Twenty-eight of the 131 sentences were modified for further understanding. Subsequent semantic analysis reached 96.18% agreement, and language equivalence (100%), cultural (99.2%) and conceptual (100%) agreement. The questionnaire was easily understood between caregivers and the expert committee judged the Brazilian version equivalent to Canadian original. Conclusion: Success was achieved in cross-cultural adaptation of the tool, members of the expert committee judged the Brazilian version equivalent to the original Canadian. The WST-Q Brazil version 4.3 for caregivers contemplated 33 wheelchair transfer skills, mobility outdoor and indoor.

Resumo Introdução: No Brasil, existe uma lacuna de ferramentas de avaliação que avaliem o uso da tecnologia assistiva e a mobilidade funcional de pessoas que usam cadeira de rodas e seus cuidadores. O Wheelchair Skills Program (WSP) é um sistema integrado que inclui instrumentos para a avaliação e o treino de usuários de cadeira de rodas, cuidadores e profissionais. Objetivos: Realizar a Adaptação transcultural para o Português do Brasil do Wheelchair Skill Test Questionnaire (WST-Q Version 4.3) - destinada aos cuidadores, um instrumento componente do WSP, além de avaliar a sua validade de face junto aos respondentes. Método: Foram aplicadas etapas interativas para produção da versão brasileira do WST-Q. Foram avaliadas as Equivalências Cultural, Idiomática, Semântica e Conceitual por um Comitê de Especialistas. Participaram quinze cuidadores informais (n=15), os quais foram avaliados com WST-Q Brasil. Resultados: Vinte e oito, das 131 frases, foram modificadas para maior entendimento. A análise semântica posterior alcançou 96,18% de concordância, e as equivalências idiomática (100%), cultural (99,2%) e conceitual (100%) de concordância O questionário se mostrou prático e de fácil compreensão entre a população alvo e comitê de especialistas. Conclusão: Obteve-se êxito na adaptação transcultural da ferramenta, os membros do comitê de especialistas julgaram a versão brasileira equivalente a original canadense. O WST-Q Brasil versão 4.3 para cuidadores contemplou 33 habilidades em cadeira de rodas de transferência, mobilidade dentro e fora de casa.

Parámetros antropométricos de atletas paralímpicos usuarios de silla de ruedas de la región del Biobío / Anthropometric parameters of paralympic athletes wheelchair users of the Biobío region

El presente estudio, tuvo como objetivo determinar el índice de masa corporal (IMC) y porcentaje de grasa corporal (%GC) de los atletas con proyección paralímpica, usuarios de sillas de ruedas, pertenecientes a la región del Biobío. El estudio fue de diseño no experimental transversal de alcance descriptivo. La evaluación antropométrica se realizó a través del protocolo ISAK. Se determinó peso y estatura utilizando una balanza con tallímetro (Seca 220), circunferencia de cintura con una cinta Lufkin y 6 pliegues con un plicómetro Harpenden (0,2 mm). El porcentaje de grasa corporal se determinó, por medio de las ecuaciones de Durnin and Womersley y Siri. Los atletas en silla de ruedas presentaron una edad promedio de 35,4 mas menos 11,2 años, obteniendo un IMC promedio de 30,0 mas menos7,1 kg/m2, y un %GC de 26,9 mas menos 7. Los atletas usuarios de silla de ruedas con proyección paralímpica, presentan un alto porcentaje de grasa corporal y clasificaciones de IMC y %GC que los categorizan en personas que presentan obesidad.

The objective of this study was to determine the body mass index (BMI) and body fat percentage of athletes with Paralympic projection, wheelchair users, belonging to the Biobío region. The study was of a non-experimental crosssectional design with a descriptive scope. The anthropometric evaluation was carried out through the ISAK protocol. Weight and height were determined using a balance with stadiometer (Seca 220), waist circumference with a Lufkin tape and 6 folds with a Harpenden pichometer (0.2mm). The percentage of body fat was determined, by means of the Durnin and Womersley equations and Siri. The athletes in wheelchairs presented an average age of 35.4 more less 11.2 years, obtaining an average BMI of 30.0 more less 7.1 kg / m2, and a GC% of 26.9 more less 7. Athletic wheelchair users with Paralympic projection, have a high body fat percentage and BMI ratings and GC% that categorize them as people who are obese

Application of Standardized Wheelchair Skills Training Program in Rehabilitation Therapeutic Clinical Teaching / 中国康复理论与实践

Objective:To introduce the standardized wheelchair skills training program into clinical teaching for the rehabilitation therapeutics students. Methods:From May, 2017 to April, 2018, 48 undergraduate interns of rehabilitation therapeutics were randomly divided into control group (n = 24) and experimental group (n = 24). Both groups accepted the regular practice, and the experimental group accepted standardized wheelchair skills training for five hours. They were tested with Wheelchair Skills Test (WST) 4.3 before, post training and four-week follow-up. The experimental group completed a questionnaire related to the wheelchair skills training. Results:The score of WST was more in the experimental group than in the control group both post training and four-week follow-up (|t| > 9.330, P < 0.001). The rate of improvement of WST scores was also more in the experimental group than in the control group (|t| = 11.214, P < 0.001). The experimental group suggested that the standardized wheelchair skills training was necessary, and should be a compulsory subject of the occupational therapy. Conclusion:The standardized wheelchair skills training is effective to improve the students' wheelchair-skills performance and understand the needs of the wheelchair users, which may be included in the curriculum program.