Article

OBJECTIVE: To describe the enabling factors and barriers experienced in the
Wheelchair Expert Evaluation Laboratory - implementation (WHEEL-i) project, in
which scientific knowledge, tools and associated systematic analyses of hand-rim
wheelchair propulsion technique, user's wheelchair propulsion capacity, wheelchair-user interface, and wheelchair mechanics were implemented in 2
rehabilitation centres. Design: Implementation project.
PATIENTS: Spinal cord injury. METHODS: In this implementation project standardized tests were
performed: wheelchair skills tests, 2 questionnaires, and a steady-state exercise
test on a treadmill in which propulsion technique (forces and torques) and
physical strain (oxygen uptake, heart rate and mechanical efficiency) were
measured. RESULTS: Good interpretation of the test outcomes was the most
important barrier. In order to discuss individual wheelchair performance results
with patients and clinicians, reference data were developed, smallest detectable
differences were calculated and software was developed to simultaneously show
video recordings and force and torque signals. CONCLUSION: Based on pilot
results, the greatest barrier to systematic monitoring of the individual
wheelchair fitting and learning process in rehabilitation with, among others,
instrumented measurement wheels, was interpretation of outcomes. For proper
interpretation of individual outcomes, the availability of reference data,
smallest detectable differences and visualization of outcomes is of utmost importance.

Langue : ANGLAIS