title: Range of motion and stroke frequency differences between manual wheelchair propulsion and pushrim-activated power-assisted wheelchair propulsion.
abstract: OBJECTIVE
  The objective of this study was to examine the use and efficacy of a pushrim-activated power-assist wheelchair (PAPAW) in the reduction of upper extremity range of motion (ROM) and stroke frequency in manual wheelchair users.
  
  
  METHODS
  Ten manual wheelchair users were evaluated using a repeated-measures design with and without the use of a PAPAW for maximum ROM of shoulder flexion/extension, abduction/adduction, internal/external rotation, and horizontal flexion/extension; elbow flexion/extension; wrist flexion/extension, supination/pronation, and ulnar/radial deviation; and stroke frequency. Participants propelled a Quickie 2 manual wheelchair configured as a PAPAW and their own wheelchair on a computer-controlled dynamometer at 3 different resistance levels and 2 different speeds.
  
  
  RESULTS
  The use of the PAPAW significantly (P < 0.05) decreased shoulder flexion/extension and horizontal flexion/extension, elbow flexion/extension, and wrist flexion/extension and ulnar/radial deviation for many speed and resistance combinations. Univariate analysis revealed that stroke frequency was unaltered in all cases.
  
  
  CONCLUSIONS
  These findings provide the foundation for studying the utility of the PAPAW in reducing the risk of upper limb injury and neuropathy in the manual wheelchair user population.
authors.affiliation: Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Corfman
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
authors.forename: Shirley G
authors.initials: SG
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D001134:Arm Injuries / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control*; D004551:Elbow Joint / Q000503:physiopathology*; D004867:Equipment Design; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D012785:Shoulder Joint / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology*; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D014910:Wheelchairs / Q000009:adverse effects*; D014955:Wrist Joint / Q000503:physiopathology*