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Biomedical subjects

E L Bontrager

Publications and source records attributed to E L Bontrager.

8 recordsLinked to original sources
PubMed2001

The effect of level of spinal cord injury on shoulder joint kinetics during manual wheelchair propulsion.

OBJECTIVE: The effects of spinal cord injury level on shoulder kinetics during manual wheelchair propulsion were studied. DESIGN: Single session data collection in a laboratory environment. METHODS: Male subjects were divided into four groups: low level paraplegia (n=17), high level paraplegia (n=19), C7 tetraplegia (C7, n=16) and C6 tetraplegia (C6, n=17). Measurements were recorded using a six-camera VICON motion analysis system, a strain gauge instrumented wheel, and wheelchair ergometer. Shoulder joint forces and moments were calculated using the inverse dynamics approach. RESULTS: Mean self-selected propulsion velocity was higher in the paraplegic (low paraplegia=90.7 m/min; high paraplegia=83.4 m/min) than tetraplegic (C7=66.5 m/min; C6=47.0 m/min) groups. After covarying for velocity, no significant differences in shoulder joint moments were identified. However, superior push force in subjects with tetraplegia (C7=21.4 N; C6=9.3 N) was significantly higher than in those with high paraplegia (7.3 N), after covarying velocity. CONCLUSIONS: The superior push force in the tetraplegic groups coupled with weakness of thoraco-humeral depressors increases susceptibility of the subacromial structures to compression. RELEVANCE: Increased vertical force at the shoulder joint, coupled with reduced shoulder depressor strength, may contribute to shoulder problems in subjects with tetraplegia. Wheelchair design modifications, combined with strength and endurance retention, should be considered to prevent shoulder pain development.

Adult↗
PubMed1999

Three dimensional upper extremity motion during manual wheelchair propulsion in men with different levels of spinal cord injury.

This investigation compared three dimensional upper extremity motion during wheelchair propulsion in persons with 4 levels of spinal cord injury: low paraplegia (n=17), high paraplegia (n=19), C7 tetraplegia (n=16), and C6 tetraplegia (n=17). Upper extremity motion was recorded as subjects manually propelled a wheelchair mounted on a stationary ergometer. For all motions measured, subjects with paraplegia had similar patterns suggesting that the wheelchair backrest adequately stabilizes the trunk in the absence of abdominal musculature. Compared with paraplegic subjects, those with tetraplegia differed primarily in the strategy used to contact the wheel. This was most evident among subjects with C6 tetraplegia who had greater wrist extension and less forearm pronation.

Adult↗
PubMed1998

Shoulder joint kinetics during the push phase of wheelchair propulsion.

The purpose of this investigation was to quantify the forces and moments at the shoulder joint during free, level wheelchair propulsion and to document changes imposed by increased speed, inclined terrain, and 15 minutes of continuous propulsion. Data were collected using a six-camera VICON motion analysis system, a strain gauge instrumented wheel, and a wheelchair ergometer. Seventeen men with low level paraplegia participated in this study. Shoulder joint forces and moments were calculated using a three-dimensional model applying the inverse dynamics approach. During free propulsion, peak shoulder joint forces were in the posterior (46 N) and superior directions (14 N), producing a peak resultant force of 51 N at an angle of 185 degrees (180 degrees = posterior). Peak shoulder joint moments were greatest in extension (14 Newton-meters [Nm]), followed by abduction (10 Nm), and internal rotation (6 Nm). With fast and inclined propulsion, peak vertical force increased by greater than 360%, and the increase in posterior force and shoulder moments ranged from 107% to 167%. At the end of 15 minutes of continuous free propulsion, there were no significant changes compared with short duration free propulsion. The increased joint loads documented during fast and inclined propulsion could lead to compression of subacromial structures against the overlying acromion.

Acceleration↗
PubMed1998

Segment velocities in normal and transtibial amputees: prosthetic design implications.

Dynamic elastic response foot and ankle prostheses (Seattle-Lite, Flex Foot, etc.) used by transtibial amputees feature substantial design improvements over conventional designs (SACH, Single Axis, etc.). Despite this progress, transtibial amputees continue to expend greater energy than normals. Increased residual limb EMG data and altered gait patterns suggest that impaired mobility may be the cause of overactive muscles in early stance. Prosthetic mobility was therefore quantified by measuring foot, shank and thigh velocities in nine transtibial amputees, wearing three different foot designs: Single Axis (SA), Seattle Lite (SL) and Flex Foot (FF). The magnitude, timing and rate of segment velocities for each prosthetic design, characterizing early stance mobility, were compared with corresponding measures in normal, nonamputee (NA) controls using Dunnett's test. Regardless of foot type, transtibial (TT) amputees walked slower than non amputee controls (63.3-65.8 m/min versus 78.5 m/min, p < 0.05) and their stride length was shorter (1.21-1.26 m versus 1.41 m, p < 0.01). In early stance, peak foot and shank velocities were lower (p < 0.01) for both the SL and FF while only shank velocity was lower (p < 0.01) with the SA compared to NA controls. Significant delays in the timing of early stance events such as peak shank velocity, peak ankle plantarflexion and peak knee flexion compromised shank and knee stability in TT amputees. Foot and shank mobility was uncontrolled with the SA design while ankle mobility was restricted by the FF and SL feet. In NA controls on the other hand, appropriate timing and rate of segment velocity changes preserved dynamic stability and forward progression in early stance. This was evidenced by rapid decreases in foot and shank velocity as the thigh velocity increased during weight acceptance. Future prosthetic designs should provide TT amputees with improved ankle mobility that attempt to capture the dynamic characteristics of a normal articulation between the foot and shank segments during the early stance weight acceptance period.

Amputation, Surgical↗
PubMed1996

Three-dimensional kinematics of wheelchair propulsion.

A three-dimensional (3-D) biomechanical model was used to determine upper extremity kinematics of 16 male subjects with low-level paraplegia while performing wheelchair propulsion (WCP). A six-camera VICON motion analysis system was used to acquire the coordinate data of ten anatomic markers. Joint axes for the wrist and elbow were defined along with the planes of motion for the upper arm (humerus) and trunk. The group's mean and standard deviation profiles were graphed for eight of the nine rotations measured during WCP. Variability in the intercycle and intersubject movement patterns were calculated using the root mean square standard deviation (RMS sigma) and the coefficient of variation (CV). Motion pattern similarities were quantified using the coefficient of multiple correlation (CMC). The intercycle (Nc > or = 6) motion patterns of individual subjects were highly consistent, similar, and repeatable during WCP. This was confirmed by low CVc values (3-31%), high CMCc values (0.724-0.996) and RMS sigma c values below 3.2 degrees. For the group, mean values of the propulsion velocity, cadence, and propulsion cycle duration were 89.7 m/min, 66.1 pushes/min, and 0.96 s, respectively. Humeral plane and rotation showed large excursions (76.1-81.6 degrees), while trunk lean and forearm carrying angle displayed relatively small ranges of motion (5.5-10.9 degrees). The intersubject (N3 = 16) motion patterns were less similar compared to individual intercycle patterns. This was evidenced by higher CVc values (12-128%) and lower CMC3 values (0.418-0.935). Intersubject humeral patterns were the most consistent while trunk lean was the least consistent. Intersubject root mean square standard deviations (RMS sigma c) were more than three times the corresponding intercycle values for all nine rotations.

Adult↗
PubMed1993

The Rancho EMG analyzer: a computerized system for gait analysis.

This paper describes a computer system which accurately defines the EMG patterns of the lower extremities during gait. Footswitches are used to identify the temporal relationships and determine the phases of the gait cycle. Fine wire electrodes, inserted in the desired muscles of the patient being tested, provide EMG signals for comparison with a normal database. The system is also usable with surface electrodes when an appropriate normal database for surface electrodes is incorporated. Descriptive qualifiers (such as 'premature onset', 'delayed cessation', 'no clinically significant EMG', 'continuous activity' etc.) are used to produce a clinically relevant printed (textual) report. The intensity filtered average (IFA) of the EMG is shown graphically with the representative profile of each stride. The IFAs for all muscles tested can be plotted together (up to six on a page) and the graphic representation of the 'raw' EMG can be produced. The methods of generating the normal database by creating time-adjusted mean profiles (TAMP) are enumerated. The clinical use of the system is discussed. A detailed analysis of 31 of the most recent patient tests for which the system was used provides an indication of its accuracy. For 86% of the 428 muscle tests examined, the EMG analyser was considered to have given the correct result as compared with a visual analysis of the raw EMG record by a trained expert. Recommendations for the use and future improvements of the EMG analyser are made.

Adolescent↗
PubMedDate not supplied

Temporal-spatial characteristics of wheelchair propulsion. Effects of level of spinal cord injury, terrain, and propulsion rate.

The purpose of this investigation was to compare the temporal-spatial characteristics of wheelchair propulsion (velocity, cycle distance, and cadence) of customary wheelchair users in conditions designed to simulate community settings. Seventy adult males with spinal cord injuries (SCI) were grouped by their level of SCI: low paraplegia (n = 17); high paraplegia (n = 19); C-7 tetraplegia (n = 17); C-6 tetraplegia (n = 17). Testing was performed in a wheelchair that had the right pushrim instrumented with force transducers. Participants propelled the test wheelchair at a self-selected, free, and fast pace over tile and carpeted floors. A wheelchair ergometer was designed to simulate loads encountered during propulsion over graded surfaces. Participants propelled the test wheelchair during ergometer simulation of 4% and 8% grades. Mean velocity, cycle distance, and cadence were calculated for each group in all test conditions. A two-way repeated measures analysis of variance and simple main effects testing for comparison across conditions and between groups were performed. For all test conditions, participants with low paraplegia were the fastest and had the longest cycle distance. With successively higher levels of SCI, velocities were slower and cycle distances shorter. During free propulsion on tile, velocities ranged from 95 m/min in low paraplegics to 55 m/min in C-6 tetraplegics. Fast propulsion velocity increased to 141 and 55 m/min, respectively. There was a significant main effect of surface for velocity such that the carpet condition was slower than the tile for all groups. Differences in velocity were most often the result of changes in cycle distance. High and low paraplegic groups were statistically similar for all test conditions. Participants with C-6 tetraplegia were significantly slower than all other groups for most test conditions. Because their fast propulsion velocities were slower than typical community demands, their ability to function independently outside the hospital setting has been further questioned.

Adult↗