Leonard A. Rozendaal

Biomechanics and physiology in active manual wheelchair propulsion.

Manual wheelchair propulsion in daily life and sports is increasingly being studied. Initially, an engineering and physiological perspective was taken. More recently a concomitant biomechanics interest is seen. Themes of biomechanical and physiological studies today are performance enhancing aspects of wheelchair use and the ergonomics of wheelchair design. Apart from the propulsion technique the focus of biomechanics research of manual wheelchair propulsion is mainly towards injury mechanisms, especially phenomena of overuse to the upper extremity. Obviously, the vehicle mechanics of wheelchairs must be included within this biological framework. Scientific research is progressing, but is still hampered by methodological limitations, such as the heterogeneity and small numbers of the population at study as well as the inconsistency of employed technologies and methodologies. There is a need for consensus regarding methodology and research strategy, and a strong need for collaboration to improve the homogeneity and size of subject groups and thus the power of the experimental results. Thus a sufficiently strong knowledge database will emerge, leading to an evidence-base of performance enhancing factors and the understanding of the risks of wheelchair sports and long-term wheelchair use. In the light of the current biomechanical and physiological knowledge of manual wheelchair propulsion there seems to be a need for the stimulation of other than hand rim propelled manual wheelchairs.

Load on the shoulder in low intensity wheelchair propulsion

OBJECTIVE To assess the mechanical load on the glenohumeral joint and on shoulder muscles during wheelchair propulsion at everyday intensities. DESIGN Model simulations based on experimental input dataBackground. Virtually nothing is known about the mechanical load on the upper extremity during wheelchair propulsion. Hand rim wheelchair propulsion is a significant risk factor for shoulder pain and injury among wheelchair users. A musculoskeletal model of the upper extremity during wheelchair propulsion will quantify the stresses placed on anatomic structures and may provide insight into the source of symptoms and injuries. METHODS Three experienced wheelchair users underwent wheelchair exercise tests at combinations of two load levels (10 and 20 W) and two velocities (0.83 and 1.39m.s(-1)) during which input data were collected for a musculoskeletal model of the upper extremity. The model was then used for the estimation of the glenohumeral contact force, as well as individual muscle forces. RESULTS Peak glenohumeral contact forces were between 800 and 1400 N (100-165% body weight) and differed significantly between load levels. Averaged over the push phase, these forces were 500-850 N. In absolute terms the m. deltoideus and rotator cuff muscles were highly active (>100N). In relative terms the load on the m. supraspinatus was high, with peak values of over 50% of its maximum attainable force. CONCLUSIONS Low intensity wheelchair propulsion does not appear to lead to high contact forces. The muscle forces in the rotator cuff and especially in the m. supraspinatus are high. This might indicate a risk for muscle damage and the subsequent development of shoulder complaints, such as rotator cuff tears. RELEVANCE Within the wheelchair user population, there is a high prevalence of upper extremity complaints. Not much is known about the causes of those complaints. Wheelchair propulsion is likely to be a major risk factor. If the (nature of this) mechanical load can be identified, specific exercise programs and/or design changes can be better tuned to prevent overuse injuries.

The Dynamics of Postural Sway Cannot Be Captured Using a One-Segment Inverted Pendulum Model: A PCA on Segment Rotations During Unperturbed Stance

Research on unperturbed stance is largely based on a one-segment inverted pendulum model. Recently, an increasing number of studies report a contribution of other major joints to postural control. Therefore this study evaluates whether the conclusions originating from the research based on a one-segment model adequately capture postural sway during unperturbed stance. High-pass filtered kinematic data (cutoff frequency 1/30 Hz) obtained over 3 min of unperturbed stance were analyzed in different ways. Variance of joint angles was analyzed. Principal-component analysis (PCA) was performed on the variance of lower leg, upper leg, and head-arms-trunk (HAT) angles, as well as on lower leg and COM angle (the orientation of the line from ankle joint to center of mass). It was found that the variance in knee and hip joint angles did not differ from the variance found in the ankle angle. The first PCA component indicated that, generally, the upper leg and HAT segments move in the same direction as the lower leg with a somewhat larger amplitude. The first PCA component relating ankle angle variance and COM angle variance indicated that the ankle joint angle displacement gives a good estimate of the COM angle displacement. The second PCA component on the segment angles partly explains the apparent discrepancy between these findings because this component points to a countermovement of the HAT relative to the ankle joint angle. It is concluded that postural control during unperturbed stance should be analyzed in terms of a multiple inverted pendulum model.

The push force pattern in manual wheelchair propulsion as a balance between cost and effect

We investigate the hypothesis that the direction of the propulsion force in manual wheelchair propulsion can be interpreted as a result of the balance between the mechanical task requirements and the drivers biomechanical possibilities. We quantify the balance at the joint level in the form of an effect-cost criterion, from which we predict the force direction that results in an optimal compromise. Kinematic and dynamic data were collected from nine habitual wheelchair users driving at four velocities (0.83, 1.11, 1.39, 1.67 m/s) and three external power levels (10, 20, 30 W). Experimental data and predictions are in good agreement in the middle and final part of the push; the effect-cost value in this region approximates the achievable maximum. Early in the push the effect-cost criterion predicts an upwards propulsion force whereas the experimental force is downwards, the difference probably being mainly attributable to the force generation dynamics of the muscles. As a result of the geometric features of large-rim manual wheelchairs, the mechanically required and biomechanically preferred force directions are not in accordance during a substantial part of the push, making even the best compromise a poor one. This may contribute to the low mechanical efficiency of manual wheelchair propulsion and the high incidence of shoulder complaints.

Stability of bipedal stance: the contribution of cocontraction and spindle feedback

Abstract. The aim of this study is to assess the contribution of cocontraction and spindle feedback to local stability during bipedal stance. To that aim, an existing nonlinear state space model of the human musculoskeletal system is linearized in a reference equilibrium state. The maximal real part of the eigenvalues of the linearized system matrix A and the low-frequency joint stiffness are used as a measure of local stability. Muscle properties, as represented in a Hill-type muscle model, are shown to improve the behavior, the improvement being larger at high cocontraction. However, even at maximal cocontraction the low-frequency joint stiffness generated by the muscle properties is insufficient to yield a locally stable system. It follows that feedback is necessary to ensure local stability. In this study, the potential contribution of spindle feedback is investigated by optimizing the feedback gains for contractile element length and velocity for each muscle. It is found that in the case of time-delayed negative feedback, it is impossible to stabilize the system on the basis of spindle feedback. When positive time-delayed feedback is allowed, a barely stable system is obtained. When the time delays are removed, the feedback gains can be chosen such that a locally stable system is obtained, indicating the limitations imposed by the presence of time delays. Finally, it is shown that for small perturbations the response of the linear system to an arbitrary perturbation is similar to that of the nonlinear system, indicating the validity of the approach used. It is concluded that the combination of muscle properties and time-delayed spindle feedback is insufficient to obtain a system with reasonable local stability.

Force direction in manual wheel chair propulsion: balance between effect and cost

OBJECTIVE To evaluate the relationship between mechanical effect and musculoskeletal cost in wheelchair propulsion. DESIGN Simulation of force direction, based on experimental data from wheelchair users. METHODS For nine wheelchair users driving at 20 W, 1.39 m/s, the force direction was compared to simulation results based on a criterion defined as the ratio of mechanical effect and musculoskeletal cost. RESULTS Simulation data compare well to the actual force direction for the middle and final parts of the push. CONCLUSIONS The musculoskeletal cost of the exerted force must be taken into account to explain the observed propulsion pattern. Experienced users appear to optimize the force pattern by balancing mechanical effect and musculoskeletal cost of the pushing action. RelevanceThe effect-cost ratio may be a useful tool in analysing and improving wheelchair design.

Interaction between the Joints in the Shoulder Mechanism: The Function of the Costoclavicular, Conoid and Trapezoid Ligaments:

By developing a measurement method based on the palpation of bony landmarks, the three-dimensional positions of the scapula and clavicle can be measured at several angles of humerus elevation. An analysis of these measurements shows the interaction between all joints of the shoulder mechanism. With the help of a biomechanical shoulder model the role of some of the extracapsular ligaments in the motion pattern of scapula and clavicle can be derived. In addition, the interaction between the rotations in the acromioclavicular and sternoclavicular joints is shown, and the possible implications for the treatment of joint problems in the shoulder are discussed.

In Vivo Dynamics of the Musculoskeletal System Cannot Be Adequately Described Using a Stiffness-Damping-Inertia Model

Background Visco-elastic properties of the (neuro-)musculoskeletal system play a fundamental role in the control of posture and movement. Often, these properties are described and identified using stiffness-damping-inertia (KBI) models. In such an approach, perturbations are applied to the (neuro-)musculoskeletal system and subsequently KBI-model parameters are optimized to obtain a best fit between simulated and experimentally observed responses. Problems with this approach may arise because a KBI-model neglects critical aspects of the real musculoskeletal system. Methodology/Principal Findings The purpose of this study was to analyze the relation between the musculoskeletal properties and the stiffness and damping estimated using a KBI-model, to analyze how this relation is affected by the nature of the perturbation and to assess the sensitivity of the estimated stiffness and damping to measurement errors. Our analyses show that the estimated stiffness and damping using KBI-models do not resemble any of the dynamical parameters of the underlying system, not even when the responses are very accurately fitted by the KBI-model. Furthermore, the stiffness and damping depend non-linearly on all the dynamical parameters of the underlying system, influenced by the nature of the perturbation and the time interval over which the KBI-model is optimized. Moreover, our analyses predict a very high sensitivity of estimated parameters to measurement errors. Conclusions/Significance The results of this study suggest that the usage of stiffness-damping-inertia models to investigate the dynamical properties of the musculoskeletal system under control by the CNS should be reconsidered.

Optical acceleration cancellation: a viable interception strategy?

Interception of fly balls requires active locomotion toward the point where catching can take place; as a result, the visual information guiding interception is affected by the catcher’s own movement. The only interception theory currently available for a catcher standing in the plane of motion of the ball is Optical Acceleration Cancellation (OAC); in this strategy, the pseudo-optical variable “optical acceleration” (OA), if nonzero, specifies how the catcher should adjust his current velocity. We formulate a precise implementation of OAC where the catcher strives to maintain OA zero at all times and analyze its implications in terms of the catcher’s interception behavior for different ball trajectories under air-friction-free, low-friction, and friction-dominated conditions. We conclude that the point in the ball trajectory where first visual contact (FVC) takes place determines to a large extent the ensuing interception behavior of the catcher. Conventional trajectories (FVC slightly above eye level, ball coming toward the catcher) result in fast acceleration to a constant velocity and successful interception. Trajectories with FVC below eye level typically result in unsatisfactory behavior of the catcher, who runs away from rather than toward the point of interception. In addition, ball trajectories are identified for which the OA equals zero even though the catcher is not on an interception course.

The influence of glenohumeral prosthesis geometry and placement on shoulder muscle forces

The authors studied the influence of a changed geometry of the glenohumeral joint on the function of the muscles with the use of a shoulder prosthesis with an anatomic design. The changed geometry is characterized by 4 parameters: orientation of the glenoid, radius of the humeral head, position of the glenohumeral joints geometric center in relation to the scapula, and position of the glenohumeral joints geometric center in relation to the humeral shaft. The effect of changes in these 4 parameters was investigated with an inverse dynamic 3-dimensional musculoskeletal model of the shoulder. This was done at 60 ° and 90 ° of abduction and flexion. Gravity was the only external force on the arm. The magnitudes of the introduced changes are assumed to be a realistic representation of a changed geometry due to the implantation of a prosthesis. In most situations, the effect of a change in the 4 parameters on the exerted muscle force was small compared with the maximum force of a muscle. However, in relation to the initial reference force in a muscle, changes with an average of 50% occurred. Changes in the geometric centers position relative to the humerus are especially important, because they are closely related to the retroversion angle and can cause changes in force of up to 300%.