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Contains fulltext : 247754.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 247754.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 247754.pdf (Publisher’s version ) (Open Access)

Marika T Leving,1 Job FM van Boven,2– 4 Sinthia Z Bosnic-Anticevich,5,6 Joyce van Cooten,1 Jaime Correia de Sousa,7 Biljana Cvetkovski,5 Richard Dekhuijzen,8 Lars Dijk,1 Marina García Pardo,9 Asparuh Gardev,10 Radosław Gawlik,11 Iris van der Ham,1 Elisabeth Sophia Hartgers-Gubbels,10 Ymke Janse,1 Federico Lavorini,12 Tiago Maricoto,13 Jiska Meijer,1 Boyd Metz,1 David B Price,14,15 Miguel Roman-Rodríguez,9 Kirsten Schuttel,1 Nilouq Stoker,1 Ioanna Tsiligianni,16 Omar S Usmani,17 Janwillem H Kocks1,2,15,18 1General Practitioners Research Institute, Groningen, the Netherlands; 2University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, the Netherlands; 3University Medical Centre Groningen, Department of Clinical Pharmacy & Pharmacology, University of Groningen, Groningen, the Netherlands; 4Medication Adherence Expertise Centre of the Northern Netherlands (MAECON), Groningen, the Netherlands; 5Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; 6Sydney Local Health District, Sydney, Australia; 7Life and Health Sciences Research Institute (ICVS), PT Government Associate Laboratory, School of Medicine, University of Minho, Braga, Portugal; 8Radboud University Medical Centre, Nijmegen, Netherlands; 9Primary Care Respiratory Research Unit, Instituto De Investigación Sanitaria De Baleares (IdISBa), Palma de Mallorca, Spain; 10Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany; 11Department of Internal Medicine, Allergology, Clinical Immunology, Medical University of Silesia, Katowice, Poland; 12Department of Experimental and Clinical Medicine, Careggi University Hospital, Florence, Italy; 13Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal; 14Centre of Academic Primary Care, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; 15Observational and Pragmatic Research Institute, Singapore; 16De

Proficiency in wheelchair propulsion is a key to independence among manual wheelchair users. While low levels of wheelchair skill relate to social isolation and dependence on others, high levels of skill correspond to higher independence, active participation and quality of life. Even though the motor learning process of handrim wheelchair propulsion is considered highly important, it is still not well understood. The goal of this thesis was to widen the understanding of this process in order to contribute to evidence-based guidelines concerning wheelchair skill acquisition, which on the long term will enhance the quality of life and participation among wheelchair users. This thesis described physiological and biomechanical changes that take place during low-intensity wheelchair practice. The results showed that motor learning in wheelchair propulsion is a very complex process with numerous interconnected aspects. Changes in the movement pattern and shoulder load occurring due to practice can vary strongly among individuals. The emergent movement pattern is most likely a result of an interplay between the personal characteristics (e.g.pain, talent), the task requirements (wheelchair type, fitting and maintenance) and the environment (surface, obstacles). Current rehabilitation practice does not yet have a proper understanding of this important process, which makes the provision of individualized evidence-based care regarding learning to use a wheelchair impossible. The implementation of wheelchair-labs, in rehabilitation and adapted sports is suggested as a solution for the future. This novel technology could allow systematic multicenter monitoring of large patient groups and assist clinicians in providing individualized diagnosis, therapy and wheelchair fitting.

The use of a manual wheelchair is critical to 1% of the world's population. Human powered wheeled mobility research has considerably matured, which has led to improved research techniques becoming available over the last decades. To increase the understanding of wheeled mobility performance, monitoring, training, skill acquisition, and optimization of the wheelchair-user interface in rehabilitation, daily life, and sports, further standardization of measurement set-ups and analyses is required. A crucial stepping-stone is the accurate measurement and standardization of external power output (measured in Watts), which is pivotal for the interpretation and comparison of experiments aiming to improve rehabilitation practice, activities of daily living, and adaptive sports. The different methodologies and advantages of accurate power output determination during overground, treadmill, and ergometer-based testing are presented and discussed in detail. Overground propulsion provides the most externally valid mode for testing, but standardization can be troublesome. Treadmill propulsion is mechanically similar to overground propulsion, but turning and accelerating is not possible. An ergometer is the most constrained and standardization is relatively easy. The goal is to stimulate good practice and standardization to facilitate the further development of theory and its application among research facilities and applied clinical and sports sciences around the world.

The use of a manual wheelchair is critical to 1% of the world's population. Human powered wheeled mobility research has considerably matured, which has led to improved research techniques becoming available over the last decades. To increase the understanding of wheeled mobility performance, monitoring, training, skill acquisition, and optimization of the wheelchair-user interface in rehabilitation, daily life, and sports, further standardization of measurement set-ups and analyses is required. A crucial stepping-stone is the accurate measurement and standardization of external power output (measured in Watts), which is pivotal for the interpretation and comparison of experiments aiming to improve rehabilitation practice, activities of daily living, and adaptive sports. The different methodologies and advantages of accurate power output determination during overground, treadmill, and ergometer-based testing are presented and discussed in detail. Overground propulsion provides the most externally valid mode for testing, but standardization can be troublesome. Treadmill propulsion is mechanically similar to overground propulsion, but turning and accelerating is not possible. An ergometer is the most constrained and standardization is relatively easy. The goal is to stimulate good practice and standardization to facilitate the further development of theory and its application among research facilities and applied clinical and sports sciences around the world., Biomechanical Engineering

The use of a manual wheelchair is critical to 1% of the world's population. Human powered wheeled mobility research has considerably matured, which has led to improved research techniques becoming available over the last decades. To increase the understanding of wheeled mobility performance, monitoring, training, skill acquisition, and optimization of the wheelchair-user interface in rehabilitation, daily life, and sports, further standardization of measurement set-ups and analyses is required. A crucial stepping-stone is the accurate measurement and standardization of external power output (measured in Watts), which is pivotal for the interpretation and comparison of experiments aiming to improve rehabilitation practice, activities of daily living, and adaptive sports. The different methodologies and advantages of accurate power output determination during overground, treadmill, and ergometer-based testing are presented and discussed in detail. Overground propulsion provides the most externally valid mode for testing, but standardization can be troublesome. Treadmill propulsion is mechanically similar to overground propulsion, but turning and accelerating is not possible. An ergometer is the most constrained and standardization is relatively easy. The goal is to stimulate good practice and standardization to facilitate the further development of theory and its application among research facilities and applied clinical and sports sciences around the world.

The use of a manual wheelchair is critical to 1% of the world's population. Human powered wheeled mobility research has considerably matured, which has led to improved research techniques becoming available over the last decades. To increase the understanding of wheeled mobility performance, monitoring, training, skill acquisition, and optimization of the wheelchair-user interface in rehabilitation, daily life, and sports, further standardization of measurement set-ups and analyses is required. A crucial stepping-stone is the accurate measurement and standardization of external power output (measured in Watts), which is pivotal for the interpretation and comparison of experiments aiming to improve rehabilitation practice, activities of daily living, and adaptive sports. The different methodologies and advantages of accurate power output determination during overground, treadmill, and ergometer-based testing are presented and discussed in detail. Overground propulsion provides the most externally valid mode for testing, but standardization can be troublesome. Treadmill propulsion is mechanically similar to overground propulsion, but turning and accelerating is not possible. An ergometer is the most constrained and standardization is relatively easy. The goal is to stimulate good practice and standardization to facilitate the further development of theory and its application among research facilities and applied clinical and sports sciences around the world., Biomechanical Engineering

Proficiency in wheelchair propulsion is a key to independence among manual wheelchair users. While low levels of wheelchair skill relate to social isolation and dependence on others, high levels of skill correspond to higher independence, active participation and quality of life. Even though the motor learning process of handrim wheelchair propulsion is considered highly important, it is still not well understood. The goal of this thesis was to widen the understanding of this process in order to contribute to evidence-based guidelines concerning wheelchair skill acquisition, which on the long term will enhance the quality of life and participation among wheelchair users. This thesis described physiological and biomechanical changes that take place during low-intensity wheelchair practice. The results showed that motor learning in wheelchair propulsion is a very complex process with numerous interconnected aspects. Changes in the movement pattern and shoulder load occurring due to practice can vary strongly among individuals. The emergent movement pattern is most likely a result of an interplay between the personal characteristics (e.g.pain, talent), the task requirements (wheelchair type, fitting and maintenance) and the environment (surface, obstacles). Current rehabilitation practice does not yet have a proper understanding of this important process, which makes the provision of individualized evidence-based care regarding learning to use a wheelchair impossible. The implementation of wheelchair-labs, in rehabilitation and adapted sports is suggested as a solution for the future. This novel technology could allow systematic multicenter monitoring of large patient groups and assist clinicians in providing individualized diagnosis, therapy and wheelchair fitting.