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• W2500978025 abstract "Rear axle adjustment has an effect on the stability of a user’s wheelchair. On delivery, a wheelchair’s axle is usually set in its most rearward and most stable position, with guidelines and cautionary adviceon its forward adjustment. This is contrary to current clinical recommendations, which advise practitioners to; ‘adjust the rear axle asfar forwards as possible without compromising the stability of the user’ (Paralyzed Veterans of America 2005). Thus, clinicians adjust the rearaxle forward incrementally, working with the wheelchair user, in order to maintain safety and maximise performance. Theoretically, a more forwardaxle position has been shown to decrease rolling resistance by reducingthe weight transferred through the front castors (Brubaker 1986).Therefore, most clinicians assume that moving the rear axle forward will make the wheelchair significantly easier to propel.This study was undertaken to investigate if this is true in straightline pushing tasks; propulsion on lino, propulsion on artificial turf (Astro),ascending a 1:12 ramp and ascending a 3” kerb. Following rear axleadjustment from the most stable position to the least stable position,castor and pushrim forces were recorded during each propulsion cycle.Tasks were performed by a group of eight experienced manualwheelchair users, all of whom had a spinal cord injury below the level of T1.To assist in the clinical application of the data a ‘Performance Capacity Ratio’ developed by Nicholson and colleagues (Nicholson,G et al. 2006), was used. This investigated the relationship between aperson’s functional performance and their capacity to perform mobility tasks when the Rear Axle Position (RAP) was adjusted. This wasexpressed as a percentage, to gauge whether a person exceeds their‘comfort zone’ when performing different pushing tasks. The ‘comfortzone’ was defined as 80% of the maximum voluntary push force a personwas capable of. The study has shown that RAP does affect capacity toperform and that subjects were more likely to exceed their comfort zonewhen performing tasks in a more stable set up. It concludes that terrainimpacts on capacity to perform, as wheelchair users are more likely toreach and exceed their capacity on terrain which imposes the greatestresistance.The synchronisation of the pushrim and castor forcemeasurements allowed a detailed examination of how the forces changedduring a typical propulsion stroke, and how this related to castor loading.It was found that castor loading was significantly affected by the RearAxle Position (RAP), but this did not translate directly into differences inpropulsion forces required to overcome increased rolling resistance for alltasks, except the kerb." @default.
• W2500978025 created "2016-08-23" @default.
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• W2500978025 date "2011-09-28" @default.
• W2500978025 modified "2023-09-26" @default.
• W2500978025 title "Every push matters" @default.
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