Article

OBJECTIVE: To explore manual wheelchair propulsion strategies for ramp ascent and
descent in snow and snow-ice-grit conditions. DESIGN: Cross-sectional study.
SETTING: Climatic Engineering and Testing Chamber (Ottawa, Canada). PARTICIPANTS:
Manual wheelchair users (N=11) who typically self-propel their wheelchair in
winter. INTERVENTIONS: Ramp ascent and descent at 3 grades (1:10, 1:12, 1:16) and
2 winter conditions (packed snow, packed snow with a freezing rain cover, and
traction grit). MAIN OUTCOMES MEASURES: Type of ascent and descent strategy,
success rate, number and severity of obstructions, average speed, and perceived
ramp navigation rating. A questionnaire regarding the subject's past experiences
with wheelchair propulsion in winter. RESULTS: Snow accumulation on ramps at 1:10
grade will render the ramp inaccessible for many wheelchair users who do not have
external assistance. For snow conditions, the transition area from the level
group to the first 2m of ramp incline were the most difficult to traverse for
both ascent and descent. All subjects were able to ascend and descend the ramp
for the ice-grit condition. Two-railing propulsion is a preferred strategy for
ice-grit ramp navigation because of enhanced trajectory control and reducing the
potential for wheel-slip problems. Backwards ramp ascent was a successful
strategy for ascent in soft-snow conditions. CONCLUSIONS: The 1:16 grade is
preferred for winter ramp navigation. Backwards ramp ascent for snow conditions
should be considered for people with sufficient shoulder and trunk range of
motion. Two handrails are recommended for exterior ramps for both propulsion and
wheelchair extraction from ruts and other snow-related obstacles. For ice ramp
navigation, the amount of grit required and the effective time (ie, time to when
grit becomes embedded in snow-ice, becoming much less effective) should be
addressed in further research. Front wheels typically available with manual
wheelchairs are not appropriate for soft-snow conditions.
CI - Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS