Nordmark E, Orban K, Hägglund G, Jarnlo GB
Department of Physical Therapy, University Hospital, Lund, Sweden
DOI: 10.1080/16501977993195100

The patterns of movement and muscle activation in wheelchair ambulation have been studied in two groups: subjects with paraplegia (n = 4) and tetraplegia (n = 3). All subjects were physically active and experienced wheelchair users. The tests were done in the subjects' own wheelchairs and under free-wheeling conditions. The tasks studied were: self-chosen normal velocity, maximal velocity and maximally accelerated start. Muscle activation was registered by surface electromyography performed on several arm and shoulder muscles. The movement pattern was studied by goniometry of the shoulder and elbow joints, as well as by observing video recordings. Speed and arm cycle frequency were also recorded. The movement pattern was divided into three phases: pull, push and recovery. Relatively concordant muscle activation patterns were noted within the groups, whereas differences were noted between the groups with regard to muscle activation, length of the pull and push phases and the velocity-dependent adaptation. The subjects with tetraplegia were more dependent on the pull phase. The self-chosen normal and maximal speeds of the subjects with tetraplegia were approximately half those of the subjects with paraplegia. Three different types of recovery movements were noted as well as a velocity-dependent adaptation. Major trunk movements during the rim phase were only noted at the maximally accelerated start. In conclusion, the results point to both similarities and differences in the movement pattern and muscle activation in individuals with para- and tetraplegia under different ambulation conditions. The differences are of such a magnitude that they are important enough to consider when teaching wheelchair techniques and developing rehabilitation programmes for different groups of patients with spinal cord injuries.

The American Paediatric Evaluation of Disability Inventory (PEDI) is a new instrument for evaluating functional performance in disabled children aged 6 months to 7.5 years. It was developed to determine a child's functional capacity and performance in three domains, self-care, mobility and social function, as reflected in scores on three scales: (i) functional skills (current capability in specific tasks), (ii) caregiver assistance (i.e. provided to facilitate the child's performance), and (iii) modifications (i.e. environmental or technical modifications needed to facilitate the child's function). The present study was designed to compare results obtained using the PEDI in a Swedish sample with the American normative data, and to analyse the content and relevance of PEDI items for use in Sweden. The PEDI was administered as a questionnaire in structured interview form to the parents of 52 non-disabled Swedish children aged 2.0-6.9 years, divided into ten age groups. Correlation analysis (Pearson's r) showed scores for the Swedish sample to manifest strong correlation with the respective American normative data, both for the functional skills (r = 0.90-0.98) and caregiver assistance (r = 0.93-0.99) scales, respectively. Scores for the modification scale were not compared. Thus, the results suggest the American normative data to be appropriate for reference purposes in Sweden.