Mesure des effets immédiats d'un entraînement sur un simulateur de fauteuil roulant manuel offrant une rétroaction haptique : un regard sur l'efficacité de la propulsion et sur les chargements aux épaules

Abstract

Near a hundred million people worldwide are manual wheelchair users, but only a few are taught how to propel their wheelchair effectively. Optimizing propulsion mechanical effectiveness could however decrease the risk of developing secondary shoulder impairments. Our team recently designed a new wheelchair simulator that provides a realtime haptic biofeedback on propulsion mechanical effectiveness all along the push phase. Haptic biofeedback uses the sense of touch to provide information to an end user. The main purpose of the study was to investigate the impacts of the training session on propulsion effectiveness and on net shoulder articular moments. Eighteen long-term manual wheelchair users with a spinal cord injury participated in a training session on the wheelchair simulator with haptic biofeedback. Handrim force and moment data, as well as upper body movements, were recorded prior, during and immediately after the training session. Propulsion mechanical effectiveness was calculated using the mechanical effective force (MEF), a squared ratio between the tangential and total forces applied on the handrims during the pushes. During the training session with haptic biofeedback, participants’ mean MEF ratio in the middle portion of the push increased up to 15.7% on their dominant side and 12.4% on their non-dominant side compared to the pretraining. Furthermore, participants generally exceeded the target MEF pattern in the first half portion of the normalized push, and achieved it more in the second half. However, net shoulder moments, and especially those in flexion and in adduction, increased significantly during the training compared to the pre-training. Finally, eight participants were able to modify their MEF pattern towards the target even during the post-training. These participants maintained a higher propulsion effectiveness without increasing the loads on their shoulders. The results of this study confirm that some manual wheelchair users are able to react to the haptic biofeedback by reaching a more effective propulsion pattern. Haptic biofeedback parameters, as well as the simulator itself, will be refined using the new knowledge gained throughout this study. These future improvements will contribute to identify optimal training parameters for teaching manual wheelchair users a more efficient propulsion technique.

Date	9 Jul 2014
Original language	French
Awarding Institution	École de technologie supérieure
Supervisor	Rachid Aissaoui (Supervisor) & Dany Gagnon (Co-supervisor)