Criterion Validity of a Field-Based Assessment of Aerobic Capacity in Wheelchair Rugby Athletes

Purpose: To confirm whether peak aerobic capacity determined during laboratory testing could be replicated during an on-court field-based test in wheelchair rugby (WR) players. Methods: Sixteen WR players performed an incremental speed-based peak oxygen uptake (V̇O2peak) test on a motorised treadmill (TM) and completed a Multi-stage Fitness Test (MFT) on a basketball court in a counter-balanced order while spirometric data were recorded. A paired t-test was performed to check for systematic error between tests. A Bland-Altman plot for V̇O2peak illustrated the agreement between the TM and MFT results and how this related to the boundaries of practical equivalence. Results: No significant differences between mean V̇O2peak were reported (TM:1.85±0.63 vs. MFT: 1.81±0.63 L.min-1; p=0.33). Bland-Altman plot for V̇O2peak suggests that the mean values are in good agreement at the group level; i.e., the exact 95% confidence limits for the ratio systematic error (0.95 to 1.02) are within the boundaries of practical equivalence (0.88 to 1.13) showing the group average TM and MFT values are interchangeable. However, consideration of the data at the level of the individual athlete suggests the TM and MFT results were not interchangeable because the 95% ratio limits of agreement either coincide with the boundaries of practical equivalence (upper limit) or fall outside (lower limit). Conclusions: Results suggest that the MFT provides a suitable test at a group level with this cohort of WR players for the assessment of V̇O2peak (range 0.97 – 3.64 L∙min-1), yet caution is noted for interchangeable use of values between tests for individual players

Propulsion biomechanics do not differ between athletic and nonathletic manual wheelchair users in their daily wheelchairs

The purpose of this study was to investigate whether athletic and nonathletic manual wheelchair users (MWU) display differences in kinetic and kinematic variables during daily wheelchair propulsion. Thirty-nine manual wheelchair users (athletic n = 25; nonathletic n = 14) propelled their own daily living wheelchair on a roller ergometer at two submaximal speeds for three minutes (1.11 m s−1 and 1.67 m s−1). A 10 camera Vicon motion capture system (Vicon, Motion Systems Ltd. Oxford, United Kingdom) collected three-dimensional kinematics of the upper limbs and thorax at 200 Hz during the final minute of each propulsion trial. Kinetics, kinematics and kinematic variability were compared between athletic and nonathletic groups. Kinematic differences were investigated using statistical parametric mapping. Athletic MWU performed significantly greater physical activity per week compared to nonathletic MWU (920 ± 601 mins vs 380 ± 147 mins, respectively). However, no significant biomechanical differences between athletic and nonathletic MWU were observed during either propulsion speed. During the 1.11 m s−1 trial wheelchair users displayed a stroke frequency of 53 ± 12 pushes/min and a contact angle of 92.5 ± 16.2°. During the 1.67 m s−1 trial the mean stroke frequency was 64 ± 22 pushes/min and contact angle was 85.4 ± 13.6°. Despite the hand being unconstrained during the recovery phase the magnitude of joint kinematic variability was similar across both glenohumeral and scapulothoracic joints during recovery and push phases. To conclude, although athletic MWU participate in more physical activity per week they adopt similar strategies to propel their daily living wheelchair. Investigations of shoulder pain and dailywheelchair propulsion do not need to distinguish between athletic and nonathletic MWU

The longitudinal relationship between shoulder pain and altered wheelchair propulsion biomechanics of manual wheelchair users

The purpose of this study was to investigate the longitudinal association between within-subject changes in shoulder pain and alterations in wheelchair propulsion biomechanics in manual wheelchair users. Eighteen (age 33 ± 11 years) manual wheelchair users propelled their own daily living wheelchair at 1.11 m.s-1 for three minutes on a dual-roller ergometer during two laboratory visits (T1 and T2) between 4 and 6 months apart. Shoulder pain was assessed using the Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI). Between visits mean PC-WUSPI scores increased by 5.4 points and varied from - 13.5 to + 20.9 points. Of the eighteen participants, nine (50%) experienced increased shoulder pain, seven (39%) no change in pain, and two (11%) decreased pain. Increasing shoulder pain severity correlated with increased contact angle (r = 0.59, P = 0.010), thorax range of motion (r = 0.60, P = 0.009) and kinetic and kinematic variability. Additionally, increasing shoulder pain was associated with reductions in peak torque (r = -0.56, P = 0.016), peak glenohumeral abduction (r = -0.69, P = 0.002), peak scapular downward rotation (r = -0.68, P = 0.002), and range of motion in glenohumeral flexion/extension and scapular angles. Group comparisons revealed that these biomechanical alterations were exhibited by individuals who experienced increased shoulder pain, whereas, propulsion biomechanics of those with no change/decreased pain remained unaltered. These findings indicate that wheelchair users exhibit a protective short-term wheelchair propulsion biomechanical response to increases in shoulder pain which may temporarily help maintain functional independence

Scapular kinematic variability during wheelchair propulsion is associated with shoulder pain in wheelchair users

The purpose of this study was to investigate whether wheelchair propulsion biomechanics differ between individuals with different magnitudes of shoulder pain. Forty (age 36 11 years) manual wheelchair users propelled their own daily living wheelchair at 1.11 m.s(-1) for three minutes on a dual-roller ergometer. Shoulder pain was evaluated using the Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI). Correlation analyses between spatio-temporal, kinetic and upper limb kinematic variables during wheelchair propulsion and PC-WUSPI scores were assessed. Furthermore, kinematic differences between wheelchair users with no or mild shoulder pain (n = 33) and moderate pain (n = 7) were investigated using statistical parametric mapping. Participant mean PC-WUSPI scores were 20.3 +/- 26.3 points and varied from zero up to 104 points. No significant correlations were observed between kinetic or spatio-temporal parameters of wheelchair propulsion and shoulder pain. However, lower inter-cycle variability of scapular internal/external rotation was associated with greater levels of shoulder pain (r = 0.35, P = 0.03). Wheelchair users with moderate pain displayed significantly lower scapular kinematic variability compared to those with mild or no pain between 17 and 51% of the push phase for internal rotation, between 31-42% and 77-100% of the push phase for downward rotation and between 28-36% and 53-65% of the push phase for posterior tilt. Lower scapular variability displayed by wheelchair users with moderate shoulder pain may reflect a more uniform distribution of repeated subacromial tissue stress imposed by propulsion. This suggests that lower scapular kinematic variability during propulsion may contribute towards the development of chronic shoulder pain. (C) 2020 Elsevier Ltd. All rights reserved

Editorial: Adapted sports:Wheeled-mobility, exercise and health

Editorial on the Research Topic Adapted sports: wheeled-mobility, exercise and health by Vegter RJK, Veeger DHEJ, Goosey-Tolfrey VL and Leicht CA. (2002) Front. Rehabilit. Sci. 3: 1015179. doi: 10.3389/fresc.2022.1015179.</p

UNILATERAL SHOULDER PAIN IS ASSOCIATED WITH ASYMMETRIES IN TENDON THICKNESS FOLLOWING MAXIMUM EXERTION IN AN ELITE WHEELCHAIR RUGBY ATHLETE: A CASE IN POINT TOWARDS INDIVIDUALIZED FEEDBACK

The purpose of this study was to describe changes in tendon thickness following maximum exertion in the symptomatic and asymptomatic shoulder of a highly trained wheelchair rugby athlete with tetraplegia. Tendon thickness of the biceps and supraspinatus on both sides were measured with ultrasound before any physical tests, after a treadmill test up to maximum exertion to define aerobic capacity, and after a 30s Wingate test to define anaerobic capacity. The athlete reported moderate to severe shoulder pain, quantified with the upper extremity pain symptom questionnaire (PSQ) on the left shoulder and no pain on the right shoulder. There was a meaningful reduction (i.e., \u3e 2 x SD) in biceps and supraspinatus tendon thickness after the physical tests at the asymptomatic shoulder with no meaningful changes at the symptomatic shoulder. Reduction in tendon thickness has been related to increased alignment of the collagen fibres or creep which is a typical response to tensile loading. While the symptomatic shoulder presented a higher peak power output, there was a significantly greater drop in maximum power output during the Wingate test. Subsequently, the greater decline in power output with fatigue in the symptomatic shoulder, may have increased loads on the asymptomatic shoulder and be related to the greater reduction in tendon thickness following exertion. This demonstrates the importance to monitor and reduce asymmetries to improve performance and prevent injury and pain

Quality assessment of an Ultra-Wide Band positioning system for indoor wheelchair court sports

Ultra-Wide Band radio positioning systems are maturing very quickly and now represent a good candidate for indoor positioning. The aim of this study was to undertake a quality assessment on the use of a commercial Ultra-Wide Band positioning system for the tracking of athletes during indoor wheelchair court sports. Several aspects have been investigated including system set-up, calibration, sensor positioning, determination of sport performance indicators and quality assessment of the output. With a simple set-up procedure, it has been demonstrated that athletes tracking can be achieved with an average horizontal positioning error of 0.37 m (s = 6 0.24 m). The distance covered can be computed after data processing with an error below 0.5% of the course length. It has also been demonstrated that the tag update rate and the number of wheelchairs on the court do not affect significantly the positioning quality; however, for highly dynamic movement tracking, higher rates are recommended for a finer dynamic recording

Characterizing the Thermal Demands and Mobility Performance During International Wheelchair Rugby Competition

ObjectiveTo determine the thermoregulatory responses and mobility performance of wheelchair rugby (WCR) players during international competition.MethodsEleven male National Team WCR players volunteered for the study. Testing occurred during a four game series against international competition (temp 24.7 ± 0.7°C, relative humidity 50.1 ± 3.6%), with movement time (MT) and gastrointestinal temperature (Tgi) recorded continuously.ResultsThe mean maximal Tgi was 38.6 ± 0.6°C (37.9–39.7) and did not significantly differ among Low-Class, Mid-Class, and High-Class athletes (p &gt; 0.05). Moreover, there was a strong and significant relationship between minutes (min) played per quarter of the game and change in Tgi (r = 0.36, p = 0.01). Athletes moved a total of 27:43 ± 9:40 min:seconds (s), spent a total of 15:02 ± 8.23 min:s in Zone 1 (53.5%), 8:19 ± 3:20 min:s in Zone 2 (31.7%), and 5:59 ± 1:51 min:s in Zone 3 (21.3%). There were no differences among classification in total movement time (p = 0.169) or for speed in Zone 1, Zone 2, or Zone 3 (p &gt; 0.05). The relationship between peak forward speed and total movement time was strong (p = 0.021, r = 0.68).ConclusionThis study demonstrated that the time spent in absolute movement zones is not classification dependent, the change in core temperature is related to movement time per quarter. Furthermore, peak speeds obtained on-court were linked to overall movement time which suggests athletes should warm-up before going on court

A telemetry-based velocometer to measure wheelchair velocity

The purpose of this paper is to present a telemetry-based velocometer that has the ability to measure wheelchair velocity. Five studies are described which provide measurements of the validity, dynamic response, reliability and resistance of the velocometer. Validity: a linear relationship was found when velocity calculated from the velocometer was plotted against three test velocities. The average root mean square deviation (ARMSD) was used to compare velocity calculated from the velocometer with velocity calculated by manual digitising at 200 Hz. The ARMSD calculated for each test speed from three trials were 0.06±0.01, 0.27±0.05 and 0.48±0.16 ms−1 at 1, 5 and 9 ms−1, respectively. Dynamic response: expressed as a percentage of the average mean trial velocity, the ARMSD for the five acceleration and five deceleration trials were 6.5±1.8% and 6.9±1.2%, respectively. Reliability was assessed from a comparison between mean trial velocity calculated from velocometer output and the speed of the motor used to spin the wheels. Expressed as a percentage of the mean trial velocity, the mean±SD of the differences were 0.00±0.17%, for the ten disc wheel trials and 0.00±0.41%, for the ten spoke wheel trials. Velocometer resistance calculated as a factor of the mechanical resistance of the wheelchair rear wheel spinning in air were −0.50 and −0.91 N, for the disc and spoke wheel, respectively. Velocometer resistance calculated as a factor of the total mechanical resistance of the wheelchair–wheelchair user system were −1.37 and −1.82 N, for the disc and spoke wheel, respectively

Horizontal crank position affects economy and upper limb kinematics of recumbent handcyclists

Purpose: To determine the effects of horizontal crank position on economy and upper limb kinematics in recumbent handcycling. Methods: Fifteen trained handcyclists performed trials at 50% and 70% of their peak aerobic power output (POPeak), determined during a maximal ramp test, in each horizontal crank position. Four horizontal crank positions, 94%, 97%, 100% and 103% of arm length, were investigated. Horizontal crank positions were defined as the distance between the acromion angle to the centre of the handgrip, while the crank arm was parallel to the floor and pointing away from the participant. Economy and upper limb kinematics were calculated during the final minute of each three-minute trial. Results:Horizontal crank position significantly affected handcycling economy at 70% POPeak (P &lt; 0.01) but not at 50% POPeak (P = 0.44). The 97% horizontal crank position (16.0 (1.5) mL·min-1·W-1) was significantly more economical than the 94% (16.7 (1.9) mL·min-1·W-1) (P = 0.04) and 103% (16.6 (1.7) mL·min-1·W-1) (P &lt; 0.01) positions. The 100 % horizontal crank position (16.2 (1.7) mL·min-1·W-1) was significantly more economical than the 103% position (P &lt;0.01). Statistical parametric mapping indicated that an increase in horizontal crank position, from 94% to 103%, caused a significant increase in elbow extension, shoulder flexion, adduction, internal rotation, scapular internal rotation, wrist flexion, clavicle depression and clavicle protraction between 0 – 50 % (0° - 180°) of the cycle (P &lt; 0.05). Conclusion:Positioning the cranks at 97% to 100% of the athletes’ arm length improved handcycling economy at 70% POPeak as, potentially, the musculature surrounding the joints of the upper limb were in a more favourable position to produce force economically.</p