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Journal of the Korean Academy of Rehabilitation Medicine 1999;23(3):559-571.
The Changes of Electromyographic Activity of Upper Extremity and Physiologic Cost Index According to Forward and Reverse Wheelchair Propulsion Methods.
Park, Eun Young , Cho, Sang Hyun , Lee, Young Hee , Yi, Chung Hwi
1Department of Rehabilitation Therapy, College of Health Science, Yonsei University.
2Institute of Health Science, Yonsei University.
3Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine.
의자차 정추진 방식과 역추진 방식에서 상지 근전도 신호와 생리적 부담지수의 비교
박은영, 조상현, 이영희1, 이충휘
연세대학교 보건과학대학 재활학과, 보건과학연구소 및 1연세대학교 원주의과대학 재활의학교실
Abstract

Objective
To compare physiological cost index of the two manual wheel chair propulsion methods: pushing the handrim forward and reversely, and to find out whether the reverse propulsion method will help prevention of the carpal tunnel syndrome in manual wheelchair users.


Method
The subjects were thirty healthy men in their twenties. All of them performed two manual wheelchair propulsion methods for two days, foreward propulsion on the first day and reverse propulsion the next day. Duration of the wheelchair propulsion was ten minutes. Electromyography (EMG) of wrist extensor groups, biceps brachii, pectoralis major, trapezius, and triceps brachii, and heart rates were recorded. The EMG activity of each individual was transformed to root mean square (RMS), EMG activity appearance time (%), and EMG activity continuance time (%).


Results
EMG activity of the wrist extensors in reverse propulsion of the wheelchair was less active compared to forward propulsion. In reverse propulsion method, energy efficiency was not significantly increased, but RMS of wrist extensor groups was significantly reduced. Contractions of trapezius and biceps brachii muscles appeared in earlier phase of propulsion.


Conclusion
We concluded that reverse propulsion of the wheelchair will be more effective method of wheelchair propulsion compared to forward propulsion in preventing carpal tunnel syndrome in long-term wheelchair users.

The reverse propulsion method in this study uses wrist extensor less, which can reduce the wrist extension movement during wheelchair propulsion. It can possibly contribute on the prevention of carpal tunnel syndrome in long-term wheelchair users.

Key Words: Electromyography, Physiological cost index, Wheel chair propulsion
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