L. Van Der Woude | University of Groningen (original) (raw)

Papers by L. Van Der Woude

Research paper thumbnail of Development of a new scale for perceived self-efficacy in manual wheeled mobility: A pilot study

Journal of Rehabilitation Medicine, 2011

Research paper thumbnail of Anaerobic power output and propulsion technique in spinal cord injured subjects during wheelchair ergometry

Journal of …, 1994

Abstract—In order to investigate the influence of the level of the spinal cord injury (SCI) on an... more Abstract—In order to investigate the influence of the level of the spinal cord injury (SCI) on anaerobic or short-term power production and propulsion technique, 23 male SCI subjects performed a 30-second sprint test on a stationary wheelchair ergometer . Kinematic parameters were ...

Research paper thumbnail of Feasibility, safety, and reliability of exercise testing using the arm-leg (Cruiser) ergometer in subjects with a lower limb amputation

Annals of Physical and Rehabilitation Medicine

Research paper thumbnail of Effects Of Warm-up And Previous Experience On Performance In Five Subsequent 15km Handcycling Time Trials

Medicine & Science in Sports & Exercise

Research paper thumbnail of 213 Successfully increasing physical activity behaviour after rehabilitation

Journal of Science and Medicine in Sport

Research paper thumbnail of The energy cost of walking in stroke survivors: (How) does holding a handrail work?

Research paper thumbnail of Evaluation of propulsion technique, wheelchair-user interface and wheelchair mechanics using commercial measurement wheels: WHEEL-i

Background / Purpose: This study was to systematically analyze propulsion technique, the wheelcha... more Background / Purpose: This study was to systematically analyze propulsion technique, the wheelchair-user interface, and wheelchair mechanics with the use of commercial instrumented measurement wheels (Optipush@, Smartwheel@) in early rehabilitation. Main conclusion: Based on these pilot results, commercial instrumented measurement wheels can help support the systematic monitoring of the individual wheelchair optimization process, as well as the underlying processes of adaptation and motor learning due to exercise and practice in early rehabilitation.

Research paper thumbnail of Hand-rim forces and gross mechanical efficiency at various frequencies of wheelchair propulsion

International journal of sports medicine, 2013

To determine the effects of push frequency changes on force application, fraction of effective fo... more To determine the effects of push frequency changes on force application, fraction of effective force (FEF) and gross efficiency (GE) during hand-rim propulsion. 8 male able-bodied participants performed five 4-min sub-maximal exercise bouts at 1.8 ms(-1); the freely chosen frequency (FCF), followed by 4 counter-balanced trials at 60, 80, 120 and 140% FCF. Kinetic data was obtained using a SMART(Wheel), measuring forces and moments. The GE was determined as the ratio of external work done and the total energy expended. Increased push frequency led to reductions in peak resultant force (P<0.05), ranging from 167 to 117 N and peak tangential force (P<0.05), ranging from 117 to 77 N. However, FEF only demonstrated a significant difference between 60% and 140% FCF (69 ± 9% and 63 ± 7, respectively; P<0.05). Work per cycle decreased significantly (P<0.05) and rate of force development increased significantly (P<0.05) with increased push frequency. GE values were significant...

Research paper thumbnail of The effect of wheel size on mobility performance in wheelchair athletes

International journal of sports medicine, 2012

The purpose of the current study was to investigate the effects of different wheel sizes, with fi... more The purpose of the current study was to investigate the effects of different wheel sizes, with fixed gear ratios, on maximal effort mobility performance in wheelchair athletes. 13 highly trained wheelchair basketball players, grouped by classification level, performed a battery of 3 field tests in an adjustable wheelchair with 3 different wheel sizes (0.59 m, 0.61 m and 0.65 m). Performance was assessed using the time taken to perform drills, with velocity and acceleration data also collected via a wheelchair velocometer. 20 m sprint time improved in the 0.65 m condition (5.58 ± 0.43 s, P=0.029) compared with 0.59 m (5.72 ± 0.40 s). Acceleration performance over the first 2 (P=0.299) and 3 (P=0.145) pushes was not statistically influenced by wheel size. However, the peak velocities reached were greater in the 0.65 m condition (4.77 ± 0.46 m ∙ s(-1), P=0.078, Effect Size [ES]=0.63) compared with 0.59 m (4.61 ± 0.40 m ∙ s(-1)). Impact velocity, calculated as the change in velocity fro...

Research paper thumbnail of The effects of rear-wheel camber on maximal effort mobility performance in wheelchair athletes

International journal of sports medicine, 2012

This study examined the effect of rear-wheel camber on maximal effort wheelchair mobility perform... more This study examined the effect of rear-wheel camber on maximal effort wheelchair mobility performance. 14 highly trained wheelchair court sport athletes performed a battery of field tests in 4 standardised camber settings (15°, 18°, 20°, 24°) with performance analysed using a velocometer. 20 m sprint times reduced in 18° (5.89±0.47 s, P=0.011) and 20° camber (5.93±0.47 s, P=0.030) compared with 24° (6.05±0.45 s). Large effect sizes revealed that 18° camber enabled greater acceleration over the first 2 (r=0.53, 95% CI=0.004 to 0.239) and 3 (r=0.59, 95% CI=0.017 to 0.170) pushes compared with 24°. Linear mobility times significantly improved (P≤0.05) in 15° (16.08±0.84 s), 18° (16.06±0.97 s) and 20° (16.22±0.84 s) camber compared with 24° (16.62±1.10 s). Although no statistically significant main effect of camber was revealed, large effect sizes (r=0.72, 95% CI=0.066 to 0.250) demonstrated that 18° camber reduced times taken to perform the manoeuvrability drill compared with 15°. It w...

Research paper thumbnail of Effects of arm frequency during synchronous and asynchronous wheelchair propulsion on efficiency

International journal of sports medicine, 2009

To further understand the possible underlying mechanisms of the low efficiencies in hand rim whee... more To further understand the possible underlying mechanisms of the low efficiencies in hand rim wheelchair propulsion, this study examined efficiency indices at different arm frequencies during two propulsion modes (synchronous and asynchronous). Fourteen male able-bodied participants performed VO2PEAK tests for both propulsion modes. Subsequently two sub-maximal exercise tests examining synchronous and asynchronous propulsion were completed at an individualised velocity (60% of VO2PEAK). The freely chosen arm frequency (FCF), followed by four counter-balanced trials at 60, 80, 120, and 140% of FCF were performed. Gross, net, and work efficiency were determined. Gross efficiency was significantly lower (p<0.05) at arm frequencies >100%, and participants were more efficient between 60 to 100% FCF. These arm frequencies corresponded to 76+/-22 to 126+/-36 and 70+/-18 to 116+/-30 pushes x min(-1) (synchronous and asynchronous respectively). Trends in VO2, gross and work efficiency s...

Research paper thumbnail of APPLIED SCIENCES Biodynamics

Research paper thumbnail of Personal characteristics and injury related factors influencing the course of manual wheelchair skill performance during initial inpatient rehabilitation of persons with a spinal cord injury

Research paper thumbnail of The longitudinal relationship between physical capacity and wheelchair skill performance during inpatient rehabilitation of persons with spinal cord injuries

Research paper thumbnail of Wheelchair racing

Research paper thumbnail of A 9-Week Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial

The American Journal of Geriatric Psychiatry, 2015

To compare training and follow-up effects of combined aerobic and strength training versus aerobi... more To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function. Using a 9-week, parallel, three-group, single-blind, randomized, controlled trial with a follow-up assessment at week 18, we assessed 109 patients with dementia (age 85.5 ± 5.1 years) in a psycho-geriatric nursing home. Each 9-week intervention consisted of 36, 30-minute sessions. A combined group (N = 37) received and completed two strength and two walking sessions per week, an aerobic group (N = 36) completed four walking sessions, and a social group (N = 36) completed four social visits per week. Cognitive and motor functions were assessed at baseline, after the 9-week intervention, and after a consecutive 9 weeks of usual care. Baseline corrected post-test scores in the combined versus the social group were higher for global cognition, visual memory, verbal memory, executive function, walking endurance, leg muscle strength, and balance. Aerobic versus social group scores were higher for executive function. Follow-up effects reversed toward baseline values. Motor improvement did not significantly mediate cognitive improvement. Compared with a nonexercise control group, a combination of aerobic and strength training is more effective than aerobic-only training in slowing cognitive and motor decline in patients with dementia. No mediating effects between improvements in cognitive function via improved motor function were found. Future research into the underlying mechanistic associations is needed.

Research paper thumbnail of Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands

The Journal of Spinal Cord Medicine, 2014

Objective To examine the relationship between wheelchair exercise capacity and life satisfaction ... more Objective To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge. Design Prospective cohort study. Subjects Persons with spinal cord injury, aged 18-65 years, and wheelchair dependent at least for long distances. Method Measurements at the start of active rehabilitation, after 3 months, at discharge from inpatient rehabilitation, and 1 and 5 years after discharge. A peak wheelchair exercise test was performed to record peak oxygen uptake (VO2peak) and peak power output (POpeak). Life satisfaction was measured as current life satisfaction and change of life satisfaction in comparison with life after spinal cord injury. Relationships between (changes in) exercise capacity and (changes in) life satisfaction were analyzed random coefficient analysis, corrected for possible confounders (age, gender, level of lesion, functional status, secondary impairments, pain, and sports activity) if necessary. Results Of 225 persons included, 130 attended two or more peak exercise tests, who were include in the analyses. Mean age at start was 39 years, 75% were male, 73% had paraplegia, and 76% had a traumatic lesion. Mean POpeak increased during the study from 32.9 to 55.9 Watts, mean VO2peak from 1.02 to 1.38 l/minute, and mean life satisfaction from 5.7 to 7.8. An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction (P = 0.01). An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction (P = 0.049). Conclusion High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients.

Research paper thumbnail of The Ergonomics of Wheelchair Configuration for Optimal Performance in the Wheelchair Court Sports

Sports Medicine, 2013

Optimising mobility performance in wheelchair court sports (basketball, rugby and tennis) is depe... more Optimising mobility performance in wheelchair court sports (basketball, rugby and tennis) is dependent on a combination of factors associated with the user, the wheelchair and the interfacing between the two. Substantial research has been attributed to the wheelchair athlete yet very little has focused on the role of the wheelchair and the wheelchair-user combination. This article aims to review relevant scientific literature that has investigated the effects of wheelchair configuration on aspects of mobility performance from an ergonomics perspective. Optimising performance from an ergonomics perspective requires a multidisciplinary approach. This has resulted in laboratory based investigations incorporating a combination of physiological and biomechanical analyses to assess the efficiency, health/safety and comfort of various wheelchair configurations. To a lesser extent, field based testing has also been incorporated to determine the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports. The available literature has demonstrated that areas of seat positioning, rear wheel camber, wheel size and hand-rim configurations can all influence the ergonomics of wheelchair performance. Certain configurations have been found to elevate the physiological demand of wheelchair propulsion, others have been associated with an increased risk of injury and some have demonstrated favourable performance on court. A consideration of all these factors is required to identify optimal wheelchair configurations. Unfortunately, a wide variety of different methodologies have immerged between studies, many of which are accompanied by limitations, thus making the identification of optimal configurations problematic. When investigating an area of wheelchair configuration, many studies have failed to adequately standardise other areas, which has prevented reliable cause and effect relationships being established. In addition, a large number of studies have explored the effects of wheelchair configuration in either able-bodied populations or in daily life or racing wheelchairs. As such the findings are not specific and transferable to athletes competing in the wheelchair court sports. This review presents evidence about the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports to better inform athletes, coaches and manufacturers about the consequences of their selections. It also provides *all changes reported are statistically significant

Research paper thumbnail of Physical capacity and physical strain in persons with tetraplegia; The role of sport activity

Spinal Cord, 1996

To determine the relationship between sport activity and physical capacity (PC) and physical stra... more To determine the relationship between sport activity and physical capacity (PC) and physical strain (PS) during standardized activities of daily living (ADL), 25 subjects with tetraplegia were studied. To quantify PC, maximal power output, peak oxygen uptake and maximal isometric force were determined on a stationary wheelchair ergometer. PS was described as the highest heart rate (expressed as a percentage of the heart rate reserve), observed during standardized ADL tasks. Multiple regression analyses showed that sport activity, lesion level and completeness of the lesion were the most important determinants of PC. An inverse relationship was found between PS during the ADL tasks and parameters of PC. Parameters of PC and sport activity were significant determinants of PS. It is concluded that a higher PC is associated with a lower PS in daily life, and that sport activity is an important determinant of Pc. Although no causal relationships could be established, due to the cross-sectional character of this study, the results support the assumption that being physically active is highly important for individuals with tetraplegia.

Research paper thumbnail of The Influence Of Push Frequency On Force Application During Steady-State Hand-rim Wheelchair Propulsion

Medicine & Science in Sports & Exercise, 2006

Research paper thumbnail of Development of a new scale for perceived self-efficacy in manual wheeled mobility: A pilot study

Journal of Rehabilitation Medicine, 2011

Research paper thumbnail of Anaerobic power output and propulsion technique in spinal cord injured subjects during wheelchair ergometry

Journal of …, 1994

Abstract—In order to investigate the influence of the level of the spinal cord injury (SCI) on an... more Abstract—In order to investigate the influence of the level of the spinal cord injury (SCI) on anaerobic or short-term power production and propulsion technique, 23 male SCI subjects performed a 30-second sprint test on a stationary wheelchair ergometer . Kinematic parameters were ...

Research paper thumbnail of Feasibility, safety, and reliability of exercise testing using the arm-leg (Cruiser) ergometer in subjects with a lower limb amputation

Annals of Physical and Rehabilitation Medicine

Research paper thumbnail of Effects Of Warm-up And Previous Experience On Performance In Five Subsequent 15km Handcycling Time Trials

Medicine & Science in Sports & Exercise

Research paper thumbnail of 213 Successfully increasing physical activity behaviour after rehabilitation

Journal of Science and Medicine in Sport

Research paper thumbnail of The energy cost of walking in stroke survivors: (How) does holding a handrail work?

Research paper thumbnail of Evaluation of propulsion technique, wheelchair-user interface and wheelchair mechanics using commercial measurement wheels: WHEEL-i

Background / Purpose: This study was to systematically analyze propulsion technique, the wheelcha... more Background / Purpose: This study was to systematically analyze propulsion technique, the wheelchair-user interface, and wheelchair mechanics with the use of commercial instrumented measurement wheels (Optipush@, Smartwheel@) in early rehabilitation. Main conclusion: Based on these pilot results, commercial instrumented measurement wheels can help support the systematic monitoring of the individual wheelchair optimization process, as well as the underlying processes of adaptation and motor learning due to exercise and practice in early rehabilitation.

Research paper thumbnail of Hand-rim forces and gross mechanical efficiency at various frequencies of wheelchair propulsion

International journal of sports medicine, 2013

To determine the effects of push frequency changes on force application, fraction of effective fo... more To determine the effects of push frequency changes on force application, fraction of effective force (FEF) and gross efficiency (GE) during hand-rim propulsion. 8 male able-bodied participants performed five 4-min sub-maximal exercise bouts at 1.8 ms(-1); the freely chosen frequency (FCF), followed by 4 counter-balanced trials at 60, 80, 120 and 140% FCF. Kinetic data was obtained using a SMART(Wheel), measuring forces and moments. The GE was determined as the ratio of external work done and the total energy expended. Increased push frequency led to reductions in peak resultant force (P<0.05), ranging from 167 to 117 N and peak tangential force (P<0.05), ranging from 117 to 77 N. However, FEF only demonstrated a significant difference between 60% and 140% FCF (69 ± 9% and 63 ± 7, respectively; P<0.05). Work per cycle decreased significantly (P<0.05) and rate of force development increased significantly (P<0.05) with increased push frequency. GE values were significant...

Research paper thumbnail of The effect of wheel size on mobility performance in wheelchair athletes

International journal of sports medicine, 2012

The purpose of the current study was to investigate the effects of different wheel sizes, with fi... more The purpose of the current study was to investigate the effects of different wheel sizes, with fixed gear ratios, on maximal effort mobility performance in wheelchair athletes. 13 highly trained wheelchair basketball players, grouped by classification level, performed a battery of 3 field tests in an adjustable wheelchair with 3 different wheel sizes (0.59 m, 0.61 m and 0.65 m). Performance was assessed using the time taken to perform drills, with velocity and acceleration data also collected via a wheelchair velocometer. 20 m sprint time improved in the 0.65 m condition (5.58 ± 0.43 s, P=0.029) compared with 0.59 m (5.72 ± 0.40 s). Acceleration performance over the first 2 (P=0.299) and 3 (P=0.145) pushes was not statistically influenced by wheel size. However, the peak velocities reached were greater in the 0.65 m condition (4.77 ± 0.46 m ∙ s(-1), P=0.078, Effect Size [ES]=0.63) compared with 0.59 m (4.61 ± 0.40 m ∙ s(-1)). Impact velocity, calculated as the change in velocity fro...

Research paper thumbnail of The effects of rear-wheel camber on maximal effort mobility performance in wheelchair athletes

International journal of sports medicine, 2012

This study examined the effect of rear-wheel camber on maximal effort wheelchair mobility perform... more This study examined the effect of rear-wheel camber on maximal effort wheelchair mobility performance. 14 highly trained wheelchair court sport athletes performed a battery of field tests in 4 standardised camber settings (15°, 18°, 20°, 24°) with performance analysed using a velocometer. 20 m sprint times reduced in 18° (5.89±0.47 s, P=0.011) and 20° camber (5.93±0.47 s, P=0.030) compared with 24° (6.05±0.45 s). Large effect sizes revealed that 18° camber enabled greater acceleration over the first 2 (r=0.53, 95% CI=0.004 to 0.239) and 3 (r=0.59, 95% CI=0.017 to 0.170) pushes compared with 24°. Linear mobility times significantly improved (P≤0.05) in 15° (16.08±0.84 s), 18° (16.06±0.97 s) and 20° (16.22±0.84 s) camber compared with 24° (16.62±1.10 s). Although no statistically significant main effect of camber was revealed, large effect sizes (r=0.72, 95% CI=0.066 to 0.250) demonstrated that 18° camber reduced times taken to perform the manoeuvrability drill compared with 15°. It w...

Research paper thumbnail of Effects of arm frequency during synchronous and asynchronous wheelchair propulsion on efficiency

International journal of sports medicine, 2009

To further understand the possible underlying mechanisms of the low efficiencies in hand rim whee... more To further understand the possible underlying mechanisms of the low efficiencies in hand rim wheelchair propulsion, this study examined efficiency indices at different arm frequencies during two propulsion modes (synchronous and asynchronous). Fourteen male able-bodied participants performed VO2PEAK tests for both propulsion modes. Subsequently two sub-maximal exercise tests examining synchronous and asynchronous propulsion were completed at an individualised velocity (60% of VO2PEAK). The freely chosen arm frequency (FCF), followed by four counter-balanced trials at 60, 80, 120, and 140% of FCF were performed. Gross, net, and work efficiency were determined. Gross efficiency was significantly lower (p<0.05) at arm frequencies >100%, and participants were more efficient between 60 to 100% FCF. These arm frequencies corresponded to 76+/-22 to 126+/-36 and 70+/-18 to 116+/-30 pushes x min(-1) (synchronous and asynchronous respectively). Trends in VO2, gross and work efficiency s...

Research paper thumbnail of APPLIED SCIENCES Biodynamics

Research paper thumbnail of Personal characteristics and injury related factors influencing the course of manual wheelchair skill performance during initial inpatient rehabilitation of persons with a spinal cord injury

Research paper thumbnail of The longitudinal relationship between physical capacity and wheelchair skill performance during inpatient rehabilitation of persons with spinal cord injuries

Research paper thumbnail of Wheelchair racing

Research paper thumbnail of A 9-Week Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial

The American Journal of Geriatric Psychiatry, 2015

To compare training and follow-up effects of combined aerobic and strength training versus aerobi... more To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function. Using a 9-week, parallel, three-group, single-blind, randomized, controlled trial with a follow-up assessment at week 18, we assessed 109 patients with dementia (age 85.5 ± 5.1 years) in a psycho-geriatric nursing home. Each 9-week intervention consisted of 36, 30-minute sessions. A combined group (N = 37) received and completed two strength and two walking sessions per week, an aerobic group (N = 36) completed four walking sessions, and a social group (N = 36) completed four social visits per week. Cognitive and motor functions were assessed at baseline, after the 9-week intervention, and after a consecutive 9 weeks of usual care. Baseline corrected post-test scores in the combined versus the social group were higher for global cognition, visual memory, verbal memory, executive function, walking endurance, leg muscle strength, and balance. Aerobic versus social group scores were higher for executive function. Follow-up effects reversed toward baseline values. Motor improvement did not significantly mediate cognitive improvement. Compared with a nonexercise control group, a combination of aerobic and strength training is more effective than aerobic-only training in slowing cognitive and motor decline in patients with dementia. No mediating effects between improvements in cognitive function via improved motor function were found. Future research into the underlying mechanistic associations is needed.

Research paper thumbnail of Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands

The Journal of Spinal Cord Medicine, 2014

Objective To examine the relationship between wheelchair exercise capacity and life satisfaction ... more Objective To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge. Design Prospective cohort study. Subjects Persons with spinal cord injury, aged 18-65 years, and wheelchair dependent at least for long distances. Method Measurements at the start of active rehabilitation, after 3 months, at discharge from inpatient rehabilitation, and 1 and 5 years after discharge. A peak wheelchair exercise test was performed to record peak oxygen uptake (VO2peak) and peak power output (POpeak). Life satisfaction was measured as current life satisfaction and change of life satisfaction in comparison with life after spinal cord injury. Relationships between (changes in) exercise capacity and (changes in) life satisfaction were analyzed random coefficient analysis, corrected for possible confounders (age, gender, level of lesion, functional status, secondary impairments, pain, and sports activity) if necessary. Results Of 225 persons included, 130 attended two or more peak exercise tests, who were include in the analyses. Mean age at start was 39 years, 75% were male, 73% had paraplegia, and 76% had a traumatic lesion. Mean POpeak increased during the study from 32.9 to 55.9 Watts, mean VO2peak from 1.02 to 1.38 l/minute, and mean life satisfaction from 5.7 to 7.8. An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction (P = 0.01). An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction (P = 0.049). Conclusion High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients.

Research paper thumbnail of The Ergonomics of Wheelchair Configuration for Optimal Performance in the Wheelchair Court Sports

Sports Medicine, 2013

Optimising mobility performance in wheelchair court sports (basketball, rugby and tennis) is depe... more Optimising mobility performance in wheelchair court sports (basketball, rugby and tennis) is dependent on a combination of factors associated with the user, the wheelchair and the interfacing between the two. Substantial research has been attributed to the wheelchair athlete yet very little has focused on the role of the wheelchair and the wheelchair-user combination. This article aims to review relevant scientific literature that has investigated the effects of wheelchair configuration on aspects of mobility performance from an ergonomics perspective. Optimising performance from an ergonomics perspective requires a multidisciplinary approach. This has resulted in laboratory based investigations incorporating a combination of physiological and biomechanical analyses to assess the efficiency, health/safety and comfort of various wheelchair configurations. To a lesser extent, field based testing has also been incorporated to determine the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports. The available literature has demonstrated that areas of seat positioning, rear wheel camber, wheel size and hand-rim configurations can all influence the ergonomics of wheelchair performance. Certain configurations have been found to elevate the physiological demand of wheelchair propulsion, others have been associated with an increased risk of injury and some have demonstrated favourable performance on court. A consideration of all these factors is required to identify optimal wheelchair configurations. Unfortunately, a wide variety of different methodologies have immerged between studies, many of which are accompanied by limitations, thus making the identification of optimal configurations problematic. When investigating an area of wheelchair configuration, many studies have failed to adequately standardise other areas, which has prevented reliable cause and effect relationships being established. In addition, a large number of studies have explored the effects of wheelchair configuration in either able-bodied populations or in daily life or racing wheelchairs. As such the findings are not specific and transferable to athletes competing in the wheelchair court sports. This review presents evidence about the effects of wheelchair configuration on aspects of mobility performance specific to the wheelchair court sports to better inform athletes, coaches and manufacturers about the consequences of their selections. It also provides *all changes reported are statistically significant

Research paper thumbnail of Physical capacity and physical strain in persons with tetraplegia; The role of sport activity

Spinal Cord, 1996

To determine the relationship between sport activity and physical capacity (PC) and physical stra... more To determine the relationship between sport activity and physical capacity (PC) and physical strain (PS) during standardized activities of daily living (ADL), 25 subjects with tetraplegia were studied. To quantify PC, maximal power output, peak oxygen uptake and maximal isometric force were determined on a stationary wheelchair ergometer. PS was described as the highest heart rate (expressed as a percentage of the heart rate reserve), observed during standardized ADL tasks. Multiple regression analyses showed that sport activity, lesion level and completeness of the lesion were the most important determinants of PC. An inverse relationship was found between PS during the ADL tasks and parameters of PC. Parameters of PC and sport activity were significant determinants of PS. It is concluded that a higher PC is associated with a lower PS in daily life, and that sport activity is an important determinant of Pc. Although no causal relationships could be established, due to the cross-sectional character of this study, the results support the assumption that being physically active is highly important for individuals with tetraplegia.

Research paper thumbnail of The Influence Of Push Frequency On Force Application During Steady-State Hand-rim Wheelchair Propulsion

Medicine & Science in Sports & Exercise, 2006