Biomechanics of Manual Wheelchair Propulsion in the Elderly

Principal Investigator: Michael L. Boninger, MD

Pepper Center Pilot Grant Program

2006-2007

There is very limited research on manual wheelchair use and mobility in the elderly. The absence of good research means that there is no evidence to evaluate Center for Medicare Services policies that impact the elderly. The long term goal of this research is to improve mobility for the elderly who require manual wheelchairs. Specifically, we are investigating the effect of rear axle position, wheelchair weight, and surface rolling resistance on the biomechanics of wheelchair propulsion in a cohort of elderly individuals representing various degrees of frailty.

Population: Men and women age 65 and older.

Specific Aims: Primary Aim: To determine the impact of wheelchair weight, axle position, and rolling resistance on manual wheelchair propulsion biomechanics in a group of elderly individuals with various degrees of frailty. Secondary Aim: To assess the relationship of two novel measures of functional performance; a maximal isometric wheelchair push force and total 6 minute wheel distance, with a traditional measure of function, velocity, and selected propulsion biomechanics in a group of elderly individuals with various degrees of frailty .

Methods: Participants will propel in four wheelchair configurations (2 axle positions and 2 weight conditions) across four different surfaces while pushrim biomechanics are recorded. Participants will also complete a six minute wheel and isometric wheelchair push as measures of functional performance. Outcome variables of interest include cadence, self-selected velocity, Rating of Perceived Exertion (RPE), resultant force, effective force, maximal force (isometric test), and total distance traveled (6 min. wheel).

Future Use of Data: Our intent is to use the information gathered from this project to develop a larger proposal exploring how proper wheelchair prescription can meet the mobility needs of the elderly.