Low-intensity wheelchair training in inactive people with long-term spinal cord injury van der Scheer, Jan

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University of Groningen Low-intensity wheelchair training in inactive people with long-term spinal cord injury van der Scheer, Jan IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2015 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): van der Scheer, J. (2015). Low-intensity wheelchair training in inactive people with long-term spinal cord injury [S.l.]: [S.n.] Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 26-11-2017

Chapter 4 Can a 15 m-overground wheelchair sprint be used to 4 Jan W. van der Scheer Sonja de Groot Riemer J.K. Vegter Med Eng Phys 2014; 36: 432-438

Chapter 4 (PO) over a 15 m-overground wheelchair sprint test can be used to assess wheel- - based on stopwatch time (time and mean velocity over 15 m) and on PO (primary - r 2 p -1 2 p - r 2 p It seems that outcomes based on stopwatch time over a 15 m-over- ed wheel can be implemented in rehabilitation practice and research settings when 60

15 m-overground wheelchair sprint to assess anaerobic work capacity - 6-8 - 3 output outcomes over a Wingate-like sprint test in a wheelchair ergometer or roller - - Alternative tests 15-17 and as such has been implemented in rehabil- 18-15 17 (r r 19 while others r 8 - - 20 In the It is not yet known how PO is expressed in a 15 m-overground sprint and whether 4 1 61

Chapter 4-7 which resembles time needed to complete a 15 m-over- -1 20 Able-bodied persons participated in this initial study on 15-m sprint outcomes - 25 on stopwatch time and PO over a 15 m-overground wheelchair sprint test can be used Participants N Table 1. N Characteristic a Fiso a a Measured when hands were on top of the handrim. Mean ± SD (range) Equipment 62

15 m-overground wheelchair sprint to assess anaerobic work capacity - 5 - We used a custom-built stationary ergometer 26 - - 25 mensions were adjusted so that it matched as closely as possible the wheelchair used Protocol with ergometer propulsion and learning to maintain the same relative velocity between 15-18 15-25 - et al. 27 4 1 63

Chapter 4 - -1-1 -1 or was unable to propel the wheel- Data processing 28 ) and analyzed using 28 20 20 Statistics p r) and 2 ) were calculated between 15-m outcomes (time-15 p 64

15 m-overground wheelchair sprint to assess anaerobic work capacity 29 - p - either time-15 m or P5-15m as the independent variable (step 1) and combined in step 200 150 PO (W) Push start Push stop Ppeak-15m 200 150 4 1 Unilateral PO (W) 100 50 0 Unilateral PO (W) 100 50 0-50 Pstart -15m P5-15m -100 0 1 2 3 4 5 6 7 8 Time (s) Figure 1. last data point representing the start angle plus 15 m in radians. - - - 263N. -50 P5-WAnT P30-WAnT -100 0 5 10 15 20 25 30 Time (s) Figure 2. 30s-wheelchair ergometer sprint and of the over the 6 successive 5-s intervals of Win- 65

Chapter 4 All subjects (N -1 r and R 2 that were calculated between 15-m sprint r 2 p 2 = p between all outcomes (r p Table 2. N PO outcome Unilateral PO (W) -1 ) -1 ) 38.1 ±14.0 1.8 ±0.3* 3.1 ±0.4* 46.3 ±17.0 1.0 ±0.2* 2.1 ±0.4* 228.0 ±71.6 N.A. 2.4 ±0.4 44.4 ±17.3 1.2 ±0.3 1.6 ±0.3 57.0 ±19.0 1.2 ±0.2* 1.5 ±0.3* Data in mean ±SD. Table 3. - N P30-WAnT P5-WAnT r R 2 r R 2 Time-15 m 0.38* 0.36* MeanVelocity-15 m a 0.42* 0.39* 0.59** 0.56** 0.62** 0.61** 0.69** 0.61** a Linear model without intercept 66

15 m-overground wheelchair sprint to assess anaerobic work capacity - - -1-1 p -1 p 2 p 2 p 2 p 2 p 4 1 MeanVelocity-15m (m/s) 2.8 2.6 2.4 2.2 2 1.8 1.6 Unilateral PO (W) Velocity (m/s) 200 150 100 50 0-50 -100 0 1 2 3 4 5 Time (s) 3 2 1 0 15m sprint WAnT 15m sprint WAnT 1.4 20 30 40 50 60 70 80 90 P5-WAnT (W) Figure 3. Scatter plot of meanvelocity-15m N line representing the linear model used to study the relationship between the outcomes over a data range than can be 15,16,19-1 0 1 2 3 4 5 Time (s) Figure 4. the interval of the highest successive 5-s gate-based 30s-wheelchair ergometer sprint 67

Chapter 4 10 0 P5-15m - P5-WAnT (W) -10-20 -30-40 -50-60 30 40 50 60 70 Unilateral PO (W) Figure 5. - plotted indicating mean difference between the outcomes, while upper and lower lines indicate Table 4. Step 1 Time-15 m (s) P5-15m (W) ß p R 2 ß p R 2 Constant 120.36 24.01 7.84 7.59 0.316 15 m-outcome -10.50 3.29 0.005 0.38 0.96 0.19 0.61 Step 2 Constant 78.96 22.88-7.01 14.95 15 m-outcome -11.53 2.64 0.001 0.88 0.20 0.70 0.21 0.005 0.63 0.26 0.22 0.265 0.63 Step 2 Constant 212.63 50.93 103.27 47.83 15 m-outcome -7.68 3.34 0.035 0.80 0.19 0.001 a -1.06 0.53 0.061 0.50-0.84 0.42 0.061 0.69 Step 2 Constant 104.77 23.63 17.04 11.13 15 m-outcome -7.50 3.43 0.044 0.81 0.23 0.002-12.96 6.75 0.073 0.49-6.97 6.24 0.278 0.64 a Measured when hands were on top of the handrim. Abbreviations: ß 2 5-s intervals of 15 m sprint. 68

15 m-overground wheelchair sprint to assess anaerobic work capacity over a 15 m-overground wheelchair sprint test can be used to assess wheelchair-spe- -1 (table -1 - - r r r sively starting to propel an inherently unstable wheelchair while this is not required in - - in which - 4 1 69

Chapter 4 - - same conclusion as based on the linear model tested in this study: stopwatch time over r p - - during an interval with relatively low handrim velocities may stronger relate to -1 r p - 70

15 m-overground wheelchair sprint to assess anaerobic work capacity compared to P5-15m (also r over Pstart-15m and Ppeak-15m since P5-15m is determined identically to the widely 25 a more homogeneous and well-accessible group compared to non-athletic wheelchair 25-15 - - by time-15 m and P5-15m (both p p ships between the tests in an able-bodied sample are similar in non-athletic wheel- - 8 and 27 We conclude that outcomes based on stopwatch time over a 15 m-overground sprint chair with an instrumented wheel can be implemented in rehabilitation practice and - 4 1 71

Chapter 4-72

15 m-overground wheelchair sprint to assess anaerobic work capacity - - - - 4 1 73

Chapter 4 - - 74

15 m-overground wheelchair sprint to assess anaerobic work capacity 4 1 75