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Biomechanical Analysis of Functional Electrical Stimulation on Trunk Musculature During Wheelchair Propulsion

Department of Occupational Therapy, Faculty of Occupational Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, Pennsylvania

Alicia M. Koontz, PhD, RET

Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, Department of Rehabilitation Science & Technology, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, akoontz{at}pitt.edu

Ronald J. Triolo, PhD

Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio, Departments of Orthopaedics and Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio

Rory A. Cooper, PhD

Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, Pennsylvania

Michael L. Boninger, MD

Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center Health System, Pittsburgh, Pennsylvania, Department of Bioengineering University of Pittsburgh, Pittsburgh, Pennsylvania, Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, University of Pittsburgh, Pittsburgh, Pennsylvania

Background. The objective of this study was to examine how surface electrical stimulation of trunk musculature influences the kinematic, kinetic, and metabolic characteristics, as well as shoulder muscle activity, during wheelchair propulsion. Methods. Eleven participants with spinal cord injury propelled their own wheelchairs on a dynamometer at a speed of 1.3 m/s for three 5-minute trials. During a propulsion trial, 1 of 3 stimulation levels (HIGH, LOW, and OFF) was randomly applied to the participant’s abdominal and back muscle groups with a surface functional electrical stimulation device. Propulsion kinetics, trunk kinematics, metabolic responses, and surface electromyographic (EMG) activity of 6 shoulder muscles were collected synchronously. Kinetic, kinematic, and EMG variables were recorded during 3 time intervals (30 seconds each) within a 5-minute trial. Metabolic variables were recorded through the entire 5-minute trial. Results. Participants with HIGH stimulation increased their gross mechanical efficiency (P = .05) during wheelchair propulsion. No differences were found in shoulder EMG activity, energy expenditure, and trunk motion between stimulation levels. Conclusion. Functional electrical stimulation on the trunk musculature has potential advantages in helping manual wheelchair users with spinal cord injury improve propulsion efficiency without placing additional demands on shoulder musculature.

Key Words: Wheelchair • Spinal cord injury • Shoulder • Kinetics • Kinematics • Electromyography • Functional electrical stimulation

This version was published on September 1, 2009

Neurorehabilitation and Neural Repair, Vol. 23, No. 7, 717-725 (2009)
DOI: 10.1177/1545968308331145


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