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Course of gross mechanical efficiency in handrim wheelchair propulsion during rehabilitation of people with spinal cord injury: a prospective cohort study.

Abstract：

OBJECTIVE:To investigate the course of mechanical efficiency of handrim wheelchair propulsion during rehabilitation of subjects with (in)complete paraplegia and tetraplegia. DESIGN:Subjects were tested at the start of active rehabilitation (t1), 3 months later (t2), and when discharged from inpatient rehabilitation (t3). They performed two 3-minute submaximal treadmill exercise blocks in a wheelchair. SETTING:Eight rehabilitation centers in the Netherlands. PARTICIPANTS:Ninety-two people with (in)complete paraplegia and tetraplegia. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Mechanical efficiency values were calculated for each block. The course of mechanical efficiency was investigated using test occasions (t1 -t3), completeness and level (paraplegia or tetraplegia) of the lesion, and power output as independent variables in a multilevel regression analysis. RESULTS:Mechanical efficiency significantly increased between t1 and t2 only. After adding level and completeness of the lesion and their interactions with time to the model, block 2 showed that subjects with paraplegia had a significantly higher mechanical efficiency than subjects with tetraplegia. Subjects with tetraplegia improved more between t1 and t2 . Differences in mechanical efficiency between subjects with paraplegia and tetraplegia could not be explained by differences in absolute and relative power output levels. CONCLUSIONS:Results showed a significant improvement in mechanical efficiency during the first 3 months of active rehabilitation. Subjects with paraplegia showed a higher mechanical efficiency than did subjects with tetraplegia, whereas the latter showed more improvement between t1 and t2 .

journal_name

Arch Phys Med Rehabil

journal_title

Archives of physical medicine and rehabilitation

authors

de Groot S,Dallmeijer AJ,Kilkens OJ,van Asbeck FW,Nene AV,Angenot EL,Post MW,van der Woude LH

doi

10.1016/j.apmr.2004.11.025

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

1452-60

issue

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(05)00075-4

journal_volume

pub_type

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Course of gross mechanical efficiency in handrim wheelchair propulsion during rehabilitation of people with spinal cord injury: a prospective cohort study.