TransKinect: a computer vision and machine learning clinical decision support system for automatic independent wheelchair transfer technique assessment.

Background: Physical and occupational therapists provide routine care for manual wheelchair users and are responsible for training and assessing the quality of transfers. These transfers can produce large loads on the upper extremity joints if improper sitting-pivot-technique is used. Methods to assess quality of transfers include the Transfer Assessment Instrument, a clinically validated tool derived from quantitative biomechanical features; however, adoption of this tool is low due to the complex usage requirements and speed of typical transfers.

Lower extremity inter-joint coupling angles and variability during gait in pediatric hypermobility spectrum disorder.

Complex musculoskeletal complications in children with hypermobility spectrum disorder (HSD) include pain, proprioception deficits, and joint instability, which may result in movement dysfunction during walking. However, no studies have explored the inter-joint coordination deficits in children with HSD. The purpose of this study was to determine the lower extremity inter-joint coupling angles, patterns, and variability during walking in children with HSD compared to children without HSD (non-HSD).

The association of pain with gait spatiotemporal parameters in children with hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorder.

Background: Children with hypermobility spectrum disorder/hypermobile Ehlers-Danlos syndrome (HSD/hEDS) have a high prevalence of chronic pain, which may influence gait dynamics. However, little is known about pain outcomes and their association with gait spatiotemporal parameters in children with HSD/hEDS.

Research Question: Does pain correlate with gait spatiotemporal parameters in children with HSD/hEDS?

Methods: Eighteen children with HSD/hEDS and eighteen typically developing (TD) children participated in the study.

BIOMECHANICAL EVALUATION OF PNEUMATIC SLEEVE ORTHOSIS FOR LOFSTRAND CRUTCHES.

Crutch walking, especially when using a swing-through gait pattern, is associated with high, repetitive joint forces, hyperextension/ulnar deviation of the wrist, and excessive palmar pressure that compresses the median nerve. To reduce these adverse effects, we designed a pneumatic sleeve orthosis that utilized a soft pneumatic actuator and secured to the crutch cuff for long-term Lofstrand crutch users. Eleven able-bodied young adult participants performed both swing-through and reciprocal crutch gait patterns with and without the custom orthosis for comparison.

Pain Characteristics and Symptom Management in Children with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorder.

Aims: This study aims to investigate pediatric hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD) pain features and management strategies.

Methods: This is a mixed-methods, cross-sectional study design using patient-reported outcomes in 21 children diagnosed with hEDS/HSD. Children who reported bothersome pain were interviewed for pain features.

The Influence of Age at Pediatric-Onset Spinal Cord Injury and Years of Wheelchair Use on Shoulder Complex Joint Dynamics During Manual Wheelchair Propulsion.

Objective: To assess the association of age at pediatric-onset spinal cord injury (SCI) and years of manual wheelchair use with shoulder dynamics.

Design: Upper extremity kinematics and hand-rim kinetics were obtained during manual wheelchair propulsion. An inverse dynamics model computed three-dimensional acromioclavicular, sternoclavicular, and glenohumeral joint dynamics.

The Effect of Age and Fall History on Lower Extremity Neuromuscular Function During Descent of a Single Transition Step.

Despite the higher injury rate of falls on steps versus level ground, few studies have examined the influence of age and fall history on step descent. The purpose of this study was to determine the lead and trail limb neuromuscular function (peak joint moments and powers, electromyographic activity) differences between young females (n = 15) and older females with (n = 15) and without (n = 15) a fall history while descending a single step. Trail limb moments and powers did not differ between groups.

Hand-rim biomechanics during geared manual wheelchair propulsion over different ground conditions in individuals with spinal cord injury.

Geared manual wheelchair wheels, a recently developed alternative propulsion mechanism, have the potential to alleviate the high upper extremity demands required for wheelchair propulsion and help decrease the risk of secondary injuries in manual wheelchair users. The objective of this study was to investigate the effects of using geared manual wheelchairs on hand-rim biomechanics of wheelchair propulsion in individuals with spinal cord injury (SCI). Seven manual wheelchair users with SCI propelled their wheelchairs equipped with geared wheels over tile, carpet, and up a ramp in low gear (gear ratio 1.

Reliability of 3D Depth Motion Sensors for Capturing Upper Body Motions and Assessing the Quality of Wheelchair Transfers.

Wheelchair users must use proper technique when performing sitting-pivot-transfers (SPTs) to prevent upper extremity pain and discomfort. Current methods to analyze the quality of SPTs include the TransKinect, a combination of machine learning (ML) models, and the Transfer Assessment Instrument (TAI), to automatically score the quality of a transfer using Microsoft Kinect V2. With the discontinuation of the V2, there is a necessity to determine the compatibility of other commercial sensors.

Three-Dimensional Biomechanics of the Trunk and Upper Extremity During Overhead Throwing in Wheelchair Lacrosse Athletes With Spinal Cord Injury.

Objective: Quantify differences in overhead throwing kinematics between wheelchair lacrosse athletes with spinal cord injury and able-bodied lacrosse athletes.

Design: This is a cross-sectional, prospective study. Motion analysis captured overhead throwing motions of five wheelchair lacrosse athletes with spinal cord injury and six able-bodied lacrosse athletes seated in a wheelchair and standing.

Effect of Rotation Sequence on Thoracohumeral Joint Kinematics during Various Shoulder Postures.

Current methods for selecting a rotation sequence to biomechanically model shoulder joint angles during motion assessment are challenging and controversial due to insufficient knowledge of their effect on the clinical interpretation of movement. Seven rotation sequences were examined by factors including incidences of gimbal lock and joint angle error in two healthy adults during 12 postures using right and left arms. This work was the first to explore the effects of each of the six Cardan angle sequences and the International Society of Biomechanics recommended YXY Euler sequence on the thoracohumeral joint in an array of postures.

Biological Sex-Related Differences in Glenohumeral Dynamics Variability during Pediatric Manual Wheelchair Propulsion.

Shoulder pain and pathology are extremely common in adult manual wheelchair users with spinal cord injury (SCI). Within this population, biological sex and variability in shoulder joint dynamics have been shown to be important contributors to both shoulder pain and pathology. Sex-related differences in shoulder dynamics variability during pediatric manual wheelchair propulsion may influence a user's lifetime risk of shoulder pain and pathology.

The influence of age and fall history on single transition step kinematics.

Background The risk of falls during locomotion increases with age, and step negotiation is one of the most hazardous types of gait for older adults. Further, a history of a fall is one of the strongest predictors of a future fall; and women fall more frequently, and incur greater medical costs, compared to men. The purpose of the study was to identify lower extremity kinematic factors associated with transition step clearance and foot placement in young women and older women with and without a fall history.

Biomechanical analysis of wheelchair athletes with paraplegia during cross-training exercises.

Context: Extreme conditioning programs (ECPs), such as CrossFit, are a relatively new method of fitness with rapid growth in individuals with paraplegia. However, it is unknown if wheelchair users are at an additional risk of musculoskeletal injury during these exercises. Biomechanical characterization is necessary to determine the safety and efficacy of ECPs as an exercise modality for wheelchair users with paraplegia.

Considering Propulsion Pattern in Therapeutic Outcomes for Children Who Use Manual Wheelchairs.

Purpose: Children who use manual wheelchairs encounter pain and injury risks to the upper body. Current literature does not describe how propulsion pattern and physiotherapeutic training methodologies impact response to treatment.

Methods: This study assesses the effect of community-based intensive physical and occupational therapy on functional outcomes over a 7-week period in pediatric manual wheelchair users.

Shoulder complex kinematics pre- and post- rotator cuff repair.

This study investigated shoulder complex joint kinematics and functional outcomes before and after full-thickness supraspinatus rotator cuff repair. Nine adults (mean age 63.4 ± 6.

A comparison of glenohumeral joint kinematics and muscle activation during standard and geared manual wheelchair mobility.

The high prevalence of upper extremity joint injuries among manual wheelchair users is largely attributed to the high repetitive loading during propulsion. The purpose of this study was to evaluate the effects of using geared wheels for manual wheelchair mobility on shoulder joint biomechanics. Fourteen able-bodied participants performed overground propulsion and ramp ascension using standard and geared manual wheelchair wheels.

Glenohumeral joint dynamics and shoulder muscle activity during geared manual wheelchair propulsion on carpeted floor in individuals with spinal cord injury.

This study investigated the effects of using geared wheels on glenohumeral joint dynamics and shoulder muscle activity during manual wheelchair propulsion. Seven veterans with spinal cord injury propelled their wheelchairs equipped with geared wheels over a carpeted floor in low gear (1.5:1) and standard gear (1:1) conditions.

Assessment of a markerless motion analysis system for manual wheelchair application.

Background: Wheelchair biomechanics research advances accessibility and clinical care for manual wheelchair users. Standardized outcome assessments are vital tools for tracking progress, but there is a strong need for more quantitative methods. A system offering kinematic, quantitative detection, with the ease of use of a standardized outcome assessment, would be optimal for repeated, longitudinal assessment of manual wheelchair users' therapeutic progress, but has yet to be offered.