Wheelchair and walking physical activity in the spinal cord injured population

Abstract

Physical Activity (PA) is widely accepted as a deterrent against all cause disease and is especially important for people with Spinal Cord Injury (SCI). People with SCI mobilise by using a wheelchair, walking or a combination of both. Current methods of objectively measuring wheelchair P A are positioned on the wrists or on the rear wheel of the wheelchair and rely on detecting bilateral repetitive wrist movements or are not capable of detecting all wheelchair movement. The main aim of this thesis was to investigate both walking and wheelchair Pain the spinal cord injured population in both the rehabilitation setting and capturing the key transition period of discharge into the community: A secondary aim was to explore the associations between objectively measured P A and clinically used outcomes in the spinal cord injured population. In order to achieve these aims a wheelchair monitoring system that was capable of accurately measuring wheel revolutions and distinguishing the direction of movement was required. A wheelchair monitoring system, consisting of a tri-axial accelerometer positioned on the rear wheel of a wheelchair and an analysis. algorithm as developed and validated. Wheelchair and walking PA levels of participants with acute SCI were measured in the rehabilitation setting and at six weeks and six months post discharge in a cross-sectional and longitudinal study and associations with clinically used outcome measures were assessed. The wheelchair monitoring system was a valid measurement tool capable of accurately measuring wheelchair P A. P A levels of people with SCI were found to vary greatly between participants. There was no statistically significant difference between PA accrued in the rehabilitation and community settings although there was a trend for PA to increase in the community. Associations were also found between wheelchair P A and age and outcome measures such as muscle strength, sensation, functional ability and physical performance. The studies within this thesis are the first to quantify and detail the wheelchair, walking and the combination of walking and wheelchair use of participants with a SCI in the rehabilitation and community settings, and to assess the associations between P A and clinically used outcome measures in the spinal cord injured population.EThOS - Electronic Theses Online ServiceGBUnited Kingdo