Investigating the challenges of air travel in the United States: a qualitative study of the lived experiences of wheelchair users with spinal cord injury or disorder.

STUDY DESIGN: Qualitative exploratory study. OBJECTIVES: To understand the lived experiences of individuals with spinal cord injuries or disorders (SCI/D) who use wheelchairs during air travel in the United States (US), with a focus on the challenges and barriers to accessing this form of transportation. SETTING: Wheelchair users with SCI/D living in the community in the US. METHODS: Semi-structured interviews were used to collect data from six wheelchair users with SCI/D. Data were analyzed using a six-step thematic analysis. RESULTS: Experiences of wheelchair users during air travel clustered into three themes; experiences interacting with the airport, experiences interacting with the airplane, and experiences across all stages of air travel. Barriers to airport accessibility were minimal. Physical barriers to airplane accessibility and damage to wheelchairs occurred when interacting with the airplane and airline staff. Undertrained staff and a shift in responsibility to the passenger with a disability impacted all stages of the experience. CONCLUSION: Wheelchair users with SCI/D encounter challenges that can result in unsafe and inaccessible air travel within the US. Adverse consequences of air travel often impact the individual's independence and quality of life during and after the flight. Participants provided recommendations to improve the air travel experience for wheelchair users, including the ability to remain in one's wheelchair while onboard the airplane.

Knee biomechanics during popular recreational and daily activities in older men.

BACKGROUND: Physical activity is recommended for older adults, including those with knee pathology. However, demands on the knee during popular recreational activities are unclear. The study purpose was to determine knee biomechanics in healthy older men during golf and bowling and compare them to activities of daily living. METHODS: Three-dimensional motion analysis was used to determine knee biomechanics in 19 healthy males (45-73 years): 11 golfers and eight bowlers. Subjects performed walking, stair ascent, stair descent, and either golf or bowling. Comparisons were made between the recreational activity and activities of daily living. RESULTS: During bowling, flexion angle at peak extensor moment was as high as during stair descent, and peak extensor moment was as high as during stair ascent. For the golf lead knee, flexion angle at peak extensor moment and peak extensor moment were as high as during stair ascent, and peak abduction moment, internal and external rotation angles were larger than during all activities of daily living. Peak external rotation angle for the golf trail knee was larger than all activities of daily living. CONCLUSION: The greatest challenge for the knee of healthy older males during bowling is eccentric control of knee flexion. Golf poses challenges in all three planes of motion for the lead knee and in the transverse plane for the trail knee. CLINICAL RELEVANCE: Comparing mechanical demands on the knee during bowling and golf to those of stair negotiation provides a reference for clinicians when recommending recreational activities for older adults with knee pathology.