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A systematic review: the influence of real time feedback on wheelchair propulsion biomechanics

Symonds, A; Barbareschi, G; Taylor, S; Holloway, C; (2018) A systematic review: the influence of real time feedback on wheelchair propulsion biomechanics. Disability and Rehabilitation: Assistive Technology , 13 (1) pp. 47-53. 10.1080/17483107.2016.1278472. Green open access

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Abstract

BACKGROUND: Clinical guidelines recommend that, in order to minimize upper limb injury risk, wheelchair users adopt a semi-circular pattern with a slow cadence and a large push arc. OBJECTIVES: To examine whether real time feedback can be used to influence manual wheelchair propulsion biomechanics. REVIEW METHODS: Clinical trials and case series comparing the use of real time feedback against no feedback were included. A general review was performed and methodological quality assessed by two independent practitioners using the Downs and Black checklist. The review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. RESULTS: Six papers met the inclusion criteria. Selected studies involved 123 participants and analysed the effect of visual and, in one case, haptic feedback. Across the studies it was shown that participants were able to achieve significant changes in propulsion biomechanics, when provided with real time feedback. However, the effect of targeting a single propulsion variable might lead to unwanted alterations in other parameters. Methodological assessment identified weaknesses in external validity. CONCLUSIONS: Visual feedback could be used to consistently increase push arc and decrease push rate, and may be the best focus for feedback training. Further investigation is required to assess such intervention during outdoor propulsion. Implications for Rehabilitation Upper limb pain and injuries are common secondary disorders that negatively affect wheelchair users' physical activity and quality of life. Clinical guidelines suggest that manual wheelchair users should aim to propel with a semi-circular pattern with low a push rate and large push arc in the range in order to minimise upper limbs' loading. Real time visual and haptic feedback are effective tools for improving propulsion biomechanics in both complete novices and experienced manual wheelchair users.

Type: Article
Title: A systematic review: the influence of real time feedback on wheelchair propulsion biomechanics
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/17483107.2016.1278472
Publisher version: http://dx.doi.org/10.1080/17483107.2016.1278472
Language: English
Additional information: © 2017 Informa UK Limited, trading as Francis & Taylor. This is an Accepted Manuscript of an article published by Taylor & Francis in the Disability and Rehabilitation: Assistive Technology on 19 January 2017, available online: http://www.tandfonline.com/10.1080/17483107.2016.1278472.
Keywords: Manual wheelchair propulsion, mechanical effective force, peak force, push arc, real time feedback, shoulder injury
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science
URI: https://discovery.ucl.ac.uk/id/eprint/1537291
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