B T Fay

The science behind mobility devices for individuals with multiple sclerosis.

There is a growing body of research related to prescription of mobility devices. This research enables clinicians and clients to make clinical decisions related to mobility based on sound research. Unfortunately, there is little research investigating appropriate prescriptions in degenerative disorders such as multiple sclerosis (MS). In this article we will review the literature on mobility devices in MS and how it can be used to assist with clinical decision-making considering the progressive nature of this condition. In addition, we will review other research not conducted on individuals with MS that is relevant to this population. Finally we will present a call for future research that should help address this critical area.

Aspects of fatigue in multiple sclerosis during manual wheelchair propulsion

Fatigue is a major concern for individuals with multiple sclerosis as it interferes with daily tasks. This study compared the fatigue experienced by nine individuals with MS to nine unimpaired controls while completing a five-minute trial of continuous wheelchair propulsion. Fatigue was quantified via changes in resultant pushrim force, rate of force rise, force efficiency, axle moment and mean power frequency of the shoulder muscles. Results show a drop in the rate of rise of pushrim force that may be related to fatigue of the biceps brachii. However, given the lack of more conclusive findings and verbal reports of extreme fatigue from case subject at the end of the trial, future consideration of fatigue in MS may need to take a central versus peripheral perspective.

EMG activity of wrist muscles during wheelchair propulsion

Wheelchair users are at an increased risk for developing carpal tunnel syndrome (CTS). The objective of this study was to use electromyography (EMG) to describe wrist flexor activity (WFA) during wheelchair propulsion. EMG data on 3 flexor muscles for one subject were collected while he propelled at a constant speed of 0.9 m/s (2 mph). The flexor carpi radialis was the most active flexor muscle during the push phase with peak and average EMG at 51% and 33% of its maximum isometric contraction value.

Comparison of propulsion kinetics and forearm EMG between two wheelchair pushrim designs

The electromyographic (EMG) activity of forearm muscles and pushrim forces were compared between a standard and an ergonomic wheelchair pushrim for a group of non-impaired subjects propelling at two and four miles per hour. The maximum EMG signals were not statistically different for any of the muscles between rims while significantly higher peak tangential, radial, and resultant forces were found for the ergonomic pushrims.