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Avaliação da vibração de corpo inteiro em usuários de cadeira de rodas : influência para o design de almofadas /Ferreira, Ana Cristina Maurício January 2019 (has links)
Orientador: Luis Carlos Paschoarelli / Resumo: Dos dispositivos de auxílio à mobilidade, a cadeira de rodas é o mais utilizado, proporcionando ao usuário, além do deslocamento, melhora na qualidade de vida, na saúde, no bem-estar social e econômico. É um equipamento comumente utilizado por tempo prolongado, estando sujeito à ocorrência de vibração e consequente transmissão da Vibração de Corpo Inteiro (VCI) ao usuário por meio das superfícies de contato, como os apoios para braços, pés, cabeça, encosto e assento. A VCI pode causar danos à saúde do usuário de cadeira de rodas se os seus níveis ultrapassarem os limites seguros. Desta forma, o objetivo principal deste trabalho foi verificar a influência das almofadas nos níveis de vibração transmitidos aos usuários de cadeira de rodas, tendo como principal foco de estudo a análise de diferentes tipos de almofadas e a vibração transmitida ao longo do eixo z, o mais afetado em posições sentadas. Também foram avaliadas as almofadas implementadas com uma superfície plana de madeira compensada. Trata-se de uma pesquisa quantitativa, aplicada, exploratória, experimental e transversal realizada com vinte e sete voluntários do gênero masculino, não usuários de cadeira de rodas. Os resultados mostram que a cadeira de rodas sem almofada transmite o menor nível de vibração [WAz=0,39m/s2]. As almofadas comerciais obtiveram valores de VCI entre WAz=0,45m/s2 e WAz=0,52m/s2. Os assentos implementados com uma superfície de madeira compensada apresentaram níveis de VCI de WAz=0,41m/s2 a WAz=... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Of the wheelchair mobility aids is the most used, providing the user, beides the displacement, improvement in the quaçity of life, health, social and economic well-being. It is a commonly used equipment for a long time, being subject to the occurrence of vibration and consequent transmission of Whole Body Vibration (WBV) to the user through contact surfaces, such as armrests, feet, headrest, backrest and seat. WBV can cause damage to the health of a wheelchair user if their levels exceed safe limits. In this way, the main objective of this work was to verify the influence of the cushions on the vibration levels transmitted to the wheelchair users, having as main focus the analysis of different types of cushions and the vibration transmitted along the z axis, the most affected in segred positions. Also evaluated were the pillows implemented with a flat plywood surface. It is a quantitative, applied, exploratory, experimental and cross-sectional study carried out with twenty-seve male volunteers, not wheelchair users. The results show that the wheelchair without cushion transmits the lowest level of vibration {WAz=0.39m/s2]. The commercial cushions obtained WBV values between WAz=0.45m/22 and WAz=0.52m/s2. The seats implemented with a plywood surface showed WBV levels of WAz=0.41m/s2 at WAz=0.44m/s2. It was concluded that the commercial cushions amplify the vibration when compared to the wheelchair without cushions, and the WBV levels measured in the research are relevant, ofte... (Complete abstract click electronic access below) / Doutor
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Jėgos ugdymo programos poveikis vežimėlių krepšinio žaidėjų specialiesiems fiziniams gebėjimams / Strength training influence on wheelchair basketball players physical characteristics and special abilitiesBaltrušaitytė, Lina 25 May 2010 (has links)
Dauguma autorių, nagrinėjusių skirtingos negalios krepšininkų žaidėjų fizinių ypatybių ir specialiųjų gebėjimų rodiklius, pabrėžė, kad sunkesnės negalios žaidėjų (1—2 balų) rodikliai blogesni negu lengvesnės. Tačiau mažai tyrimų atlikta nagrinėjant programų poveikį vežimėlių krepšinio žaidėjų fizinėms ypatybėms ir specialiesiems gebėjimams. Šiuo požiūriu aktualūs ir nauji tyrimai nagrinėjantys jėgos ugdymo programos poveikį vežimėlių krepšinio žaidėjų fizinėms ypatybėms ir specialiesiems gebėjimams.
Tyrimo tikslas: nustatyti ir įvertinti jėgos ugdymo programos poveikį vežimėlių krepšinio žaidėjų specialiesiems fiziniams gebėjimams.
Tyrimo tikslui įgyvendinti buvo sprendžiami šie pagrindiniai uždaviniai:
1. Nustatyti ir įvertinti jėgos ugdymo programos įtaką vežimėlių krepšinio žaidėjų jėgos rodiklių kaitai negalios sunkumo laipsnio aspektu (pagal klasifikacijos balus).
2. Nustatyti ir įvertinti jėgos programos poveikį vežimėlių krepšinio žaidėjų vežimėlio ir kamuolio valdymo specialiesiems gebėjimams ir palyginti su įprastinės programos rodikliais.
3. Nustatyti ir įvertinti jėgos poveikį vežimėlių krepšinio žaidėjų važiavimo vežimėliu specialiesiems gebėjimams ir palyginti su įprastinės programos rodikliais.
4. Nustatyti ir įvertinti jėgos programos poveikį vežimėlių krepšinio žaidėjų kamuolio metimo ir perdavimo tikslumo specialiesiems gebėjimams ir palyginti su įprastinės programos rodikliais.
Tiriamieji dalyvavo Paraplegikų asociacijos Landšafto terapijos ir... [toliau žr. visą tekstą] / Most of the authors, researching on physical characteristics and special abilities indicators of basketball players with a various level of disability, noted that rates of the players with the highest degree of disability (on the scale of 1-2 points) are worse than of those with a disability on a slighter scale. However little research has been done on the influence of the programs dedicated to wheelchair basketball players’ physical characteristics and special abilities. In this case, new research on the influence of strength training program on wheelchair basketball players’ physical characteristics and special abilities is a matter of great relevance.
Aim of the study:
1. Measure and evaluate the influence of strength training program on wheelchair basketball players’ physical characteristics.
2. Measure and evaluate the influence of strength training on wheelchair basketball players’ velocity and agility.
3. Measure and evaluate the influence of strength training on wheelchair basketball players’ aerobic and anaerobic endurance.
4. Measure and evaluate the influence of strength training on wheelchair basketball players’ aim to shoot and ball-passing accuracy special abilities.
Volunteers participated in two-week ordinary program camp and two week strength training program camp, both held at Paraplegic Association Landscape Therapy and Recreation Centre in Monciskes in 2009. Special physical abilities tests were performed on 54 wheelchair basketball players. Based on... [to full text]
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Alla barns lekplats : En studie om tillgängligheten på lekplatser / Every Child's Playground : A Study on Availability at PlaygroundsAbdul Al, Fatima January 2017 (has links)
Sverige har länge varit ledande inom tillgänglighet. Genom införandet av begreppen ”tillgänglighet” och ”användbarhet” har man genom Plan- och bygglagen och Boverkets riktlinjer ställt krav på den fysiska miljön. Ca 7 000 barn i Sverige är rörelsehindrade. Ungefär hälften av dessa barn använder en rullstol. Trots att alla barn har rätt till lek, är det intressant att undersöka huruvida alla barn ges möjlighet att utnyttja denna rättighet. Efter att ha uppmärksammat Helsingborgs stads kreativa lekplatsbyggen, dök frågan kring huruvida alla barn har möjlighet att leka på dessa lekplatser, upp. Syftet med arbetet är att belysa vikten av tillgängliga lekplatser, samt att undersöka hur tillgängligheten på lekplatser kan förbättras och vilka anpassningar som krävs för att förbättra tillgängligheten för rullstolsburna barn. I detta arbete görs en litteraturstudie, med fokus på regelverk och litteratur kopplad till tillgänglighet. En fallstudie görs i form av platsbesök på 8 lekplatser i Helsingborg, som underlag för en jämförelse. En intervju görs med Johanna Elgström, landskapsarkitekt på Helsingborgs stad. Slutsatsen av detta arbete är att lekplatser där man fokuserat mer på tillgänglighet ofta är mer tillgängliga och användbara för barn i rullstol. Dock krävs incitament för att säkerställa en tillgänglig och användbar lekplatsmiljö, samt tydligare definition av dessa begrepp. Genom att ha en lekplats som är tillgänglig och användbar för de flesta, gynnas den sociala hållbarheten. Slutsatsen av detta arbete blir således att säkerställandet av tillgängliga och användbara lekplatser gynnar rullstolsburna barns möjlighet till socialt samspel. / Sweden is one of the leading countries when it comes to availability in the physical environment. Approximately 7 000 children in Sweden are disabled. Half of these children use a wheelchair. It is every child’s right to play, and it’s thereby interesting to know whether every child is given the opportunity to use a playground. In the county of Helsingborg there are playgrounds appealing to many children, although the question is whether every child is given the chance to play at these playgrounds. The aim of this study is to highlight the importance of availability at playgrounds and outline ways to improve the availability. The method used in this thesis is a literature study, focusing on legal framework and literature about availability, usability and playgrounds. The case study provides information about eight playgrounds in Helsingborg. There is also an interview with landscape architect Johanna Elgström. Playgrounds where availability has been prioritized are often more available and useable for wheelchair-bound children. Still, the legal framework is in need of a more precise definition of availability and usability to ensure that playgrounds are suitable for children using a wheelchair. The playgrounds that are more available and useable can favor children using a wheelchair and give them the opportunity to socially interact with other children.
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Supporting the prescription of exercise in spinal cord injured populationsPaulson, Thomas A. W. January 2013 (has links)
Following a spinal cord injury (SCI), participation in regular exercise can enhance physical capacity and performance in activities of daily living. With this in mind, the use of subjective ratings of perceived exertion (RPE) may provide an easy-to-administer alternative to traditional methods of regulating exercise intensity (e.g. heart rate and power output (PO)). A physically active lifestyle is also associated with a reduced risk of cardiovascular disease, in part because exercise exerts anti-inflammatory effects. Examining the plasma response of inflammation-mediating chemical messengers, known as cytokines, to traditional and novel exercise modalities may help maximise the anti-inflammatory potential of regular exercise. Participants with a cervical level SCI successfully self-regulated a 20 min bout of moderate intensity wheelchair propulsion (Chapter three). No differences in physiological or PO responses were observed during the imposed-intensity and self-regulated wheelchair propulsion in the trained population group. In a non-SCI group of novice wheelchair-users, a differentiated RPE specific to the exercising muscle mass (RPEP) was the dominant perceptual signal during submaximal wheelchair propulsion (Chapter four). The novice group successfully self-regulated a 12 min bout of moderate intensity wheelchair propulsion, comprising of a discontinuous 3 x 4 min protocol, using differentiated RPEP. In contrast, a more accurate self-regulation of light intensity wheelchair propulsion was observed when employing traditional overall RPE compared to RPEP. Following strenuous wheelchair propulsion, plasma concentrations of the inflammation-mediating cytokine interleukin-6 (IL-6) were significantly elevated in non-SCI and thoracic level SCI participants (Chapter five). Impaired sympathetic nervous system (SNS) function was associated with a reduced IL-6 response in participants with a cervical level SCI. The plasma IL-6 response to 30 min moderate intensity (60% VO2peak) arm-crank ergometry (ACE) was associated with an elevation in the anti-inflammatory cytokine IL-1 receptor antagonist (IL-1ra) independent of SNS activation (Chapter six). Light intensity ACE resulted in a small, significant plasma IL-6 response but no IL-1ra response. The addition of functional electrical stimulation-evoked lower-limb cycling to concurrent hand cycling, termed hybrid exercise, resulted in a greater plasma IL-6 response compared to moderate intensity hand cycling alone in participants with a thoracic level SCI (Chapter seven).
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Investigating energy expenditure in wheelchair athletesCroft, Louise January 2012 (has links)
The increased participation in elite wheelchair sport has provided the need to investigate the physiological requirements of wheelchair sporting competition and daily wheelchair propulsion. However, from a nutritional perspective, guidelines that have been established from the able-bodied population tend to be used by the practitioners working in disability sport and it is not known whether this information is directly transferable to the wheelchair athlete. Wheelchair sport is complex and athletes differ with respect to their sports classification based on factors relating to disability and functional capacity. Therefore, if nutritional guidance is required to optimise performance then information regarding energy expenditure (EE) in the wheelchair sports population becomes important for specific feedback. The aim of this thesis was to investigate EE in wheelchair athletes. The results from Chapter 3 found resting energy expenditure (REE) in tetraplegic athletes to be lower than that calculated using predictive equations derived from an ablebodied cohort. However, paraplegic athletes showed comparable values to those which were predicted, suggesting these equations may be of use in paraplegic athletes. Chapter 4 extended this work and found similarities in the REE of the two aforementioned cohorts. This could have been due to the similarities that were found in their total-body fat free mass (FFM). The results from Chapter 5 showed EE reduced after both a short 36 minute exposure of wheelchair propulsion and after 3 weeks of wheelchair propulsion practice in novice wheelchair users. Temporal parameters improved after the practice period, suggesting there is an association between EE and propulsion technique. Chapter 6 extended these findings with results confirming that experienced wheelchair users expended significantly less energy during wheelchair propulsion than novice individuals who had up to 3 weeks practice. It is clear that EE of daily wheelchair ambulation should not be a generic value and different levels of experience must be considered so that the nutritional needs can be tailored accordingly. Chapters 7 and 8 examined the physiological demands of elite competitive wheelchair basketball players in relation to the International Wheelchair Basketball Federation (IWBF) classification categories and identified differences in the physiological demands and physiological fitness of wheelchair basketball and tennis players. These results found that IWBF Class 3 - 4.5 (high point) players expended more energy per hour during competition than those with a lower classification (IWBF Class 1 - 2.5). However, when actual playing time was considered the low classification group showed a similar EE to the higher classification group. Furthermore, wheelchair basketball players had a higher EE per hour than wheelchair tennis players during elite competition. However, the wheelchair tennis players spent a significantly longer duration on court resulting in similar EE during a typical competition within each sport. This suggests nutritional advice should be tailored both to the duration of competitive play (where EE may be similar between sports (basketball vs. tennis)); and to training (where athletes with a higher functional capacity may have higher EE). This thesis revealed several important physiological considerations to appreciate when investigating the EE of wheelchair sportsmen and women. Findings would suggest that type of disability, wheelchair propulsion experience and sport classification are all important considerations for the accurate assessment of EE in this cohort of athletes.
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Emotional intelligence in diverse populations : theory to interventionDiehl, Caren January 2010 (has links)
This research tested the relationship between Emotional Intelligence (EI) and mood states prior to performance, using two culturally diverse populations and using a mixed methodology. The objective was to explore whether there were cultural differences between the two samples thereafter exploring whether EI can be enhanced in the two cultures, using a psychological skills intervention. Phase 1 and 2 used the BRUMS-32 (Terry et al., 1999), and the EIS (Schutte et al., 1998) to investigate mood states and EI among a sample of UK wheelchair basketball players (phase 1: n = 51), and Ghanaian footballers (phase 2: n = 70). Five semi-structured interviews were also completed in phase 1. In phase 3 interventions (goal-setting, self-talk, relaxation and daily diaries) were used to enhance EI in a sample of UK wheelchair basketball players (n = 6) and Ghanaian football players (n = 8). Self-talk questionnaires, daily diaries, EIS and structured interviews were used to collect data during the intervention. Phase 1 MANOVA results showed that EI was related to mood states associated with optimal and dysfunctional performance (Wilks' Lambda 8.7 = .01, F = 74.76, P = .00, Partial Eta2 = .99) and indicated that optimism and utilisation of emotions contributed significantly to variation in mood by performance. Four key themes emerged from semi-structured interviews: antecedents of emotions; emotion and performance; emotional intelligence; and coping with emotions. Results suggested that EI correlated with performance. Phase 2, MANOVA results showed that EI was related to mood states associated with optimal and dysfunctional performance (Wilks' Lambda 8.40 = .50, F = 7.82, P < .00, Partial Eta2 = .50) and indicated that emotion regulation and appraisal of other‟s emotions contributed significantly to variations in mood by performance. When seen collectively, results of phase 1 and 2 indicate that there were cultural differences between the two populations.Phase 3 indicated that in both populations EI could be enhanced for some of the participants. Culture could be an explanation for the intervention only partially working. The EI theory or the EIS may only work in the culture it was developed in as it did not seem to detect changes in the Ghanaian sample.
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The influence of altering wheelchair propulsion technique on upper extremity demandRankin, Jeffery Wade 27 October 2010 (has links)
Most manual wheelchair users will experience upper extremity injury and pain during their lifetime, which can be partly attributed to the high load requirements, repetitive motions and extreme joint postures required during wheelchair propulsion. Recent efforts have attempted to determine how different propulsion techniques influence upper extremity demand using broad measures of demand (e.g., metabolic cost). However studies using more specific measures (e.g., muscle stress), have greater potential to determine how altering propulsion technique influences demand. The goal of this research was to use a musculoskeletal model with forward dynamics simulations of wheelchair propulsion to determine how altering propulsion technique influences muscle demand. Three studies were performed to achieve this goal.
In the first study, a wheelchair propulsion simulation was used with a segment power analysis to identify muscle functional roles. The analysis showed that muscles contributed to either the push (i.e. delivering handrim power) or recovery (i.e. repositioning the hand) subtasks, with the transition period between the subtasks requiring high muscle co-contraction. The high co-contraction suggests that future studies focused on altering transition period biomechanics may have the greatest potential to reduce upper extremity demand. The second study investigated how changing the fraction effective force (i.e. the ratio of the tangential to total handrim force, FEF) influenced muscle demand. Simulations maximizing and minimizing FEF both had higher muscle work and stress relative to the nominal simulation. Therefore, the optimal FEF value appears to balance increasing FEF with minimizing upper extremity demand and care should be taken when using FEF to reduce demand. In the third study, simulations of biofeedback trials were used to determine the influence of cadence, push angle and peak handrim force on muscle demand. Although minimizing peak force had the lowest total muscle stress, individual stresses of many muscles were >20% and the simulation had the highest cadence, suggesting that this variable may not reduce demand. Instead minimizing cadence may be most effective, which had the lowest total muscle work and slowest cadence. These results have important implications for designing effective rehabilitation strategies that can reduce upper extremity injury and pain among manual wheelchair users. / text
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Electroencephalography (EEG)-based brain computer interfaces for rehabilitationHuang, Dandan 25 April 2012 (has links)
Objective: Brain-computer interface (BCI) technologies have been the subject of study for the past decades to help restore functions for people with severe motor disabilities and to improve their quality of life. BCI research can be generally categorized by control signals (invasive/non-invasive) or applications (e.g. neuroprosthetics/brain-actuated wheelchairs), and efforts have been devoted to better understand the characteristics and possible uses of brain signals. The purpose of this research is to explore the feasibility of a non-invasive BCI system with the combination of unique sensorimotor-rhythm (SMR) features. Specifically, a 2D virtual wheelchair control BCI is implemented to extend the application of previously designed 2D cursor control BCI, and the feasibility of the prototype is tested in electroencephalography (EEG) experiments; guidance on enhancing system performance is provided by a simulation incorporating intelligent control approaches under different EEG decoding accuracies; pattern recognition methods are explored to provide optimized classification results; and a hybrid BCI system is built to enhance the usability of the wheelchair BCI system. Methods: In the virtual wheelchair control study, a creative and user friendly control strategy was proposed, and a paradigm was designed in Matlab, providing a virtual environment for control experiments; five subjects performed physical/imagined left/right hand movements or non-control tasks to control the virtual wheelchair to move forward, turn left/right or stop; 2-step classification methods were employed and the performance was evaluated by hit rate and control time. Feature analysis and time-frequency analysis were conducted to examine the spatial, temporal and frequency properties of the utilized SMR features, i.e. event-related desynchronization (ERD) and post-movement event-related synchronization (ERS). The simulation incorporated intelligent control methods, and evaluated navigation and positioning performance with/without obstacles under different EEG decoding accuracies, to better guide optimization. Classification methods were explored considering different feature sets, tuned classifier parameters and the simulation results, and a recommendation was provided to the proposed system. In the steady state visual evoked potential (SSVEP) system for hybrid BCI study, a paradigm was designed, and an electric circuit system was built to provide visual stimulus, involving SSVEP as another type of signal being used to drive the EEG BCI system. Experiments were conducted and classification methods were explored to evaluate the system performance. Results: ERD was observed on both hemispheres during hand's movement or motor imagery; ERS was observed on the contralateral hemisphere after movement or motor imagery stopped; five subjects participated in the continuous 2D virtual wheelchair control study and 4 of them hit the target with 100% hit rate in their best set with motor imagery. The simulation results indicated that the average hit rate with 10 obstacles can get above 95% for pass-door tests and above 70% for positioning tests, with EEG decoding accuracies of 70% for Non-Idle signals and 80% for idle signals. Classification methods showed that with properly tuned parameters, an average of about 70%-80% decoding accuracy for all the classifiers could be reached, which reached the requirements set by the simulation test. Initial test on the SSVEP BCI system exhibited high classification accuracy, which may extend the usability of the wheelchair system to a larger population when finally combined with ERD/ERS BCI system. Conclusion: This research investigated the feasibility of using both ERD and ERS associated with natural hand's motor imagery, aiming to implement practical BCI systems for the end users in the rehabilitation stage. The simulation with intelligent controls provided guides and requirements for EEG decoding accuracies, based on which pattern recognition methods were explored; properly selected features and adjusted parameters enabled the classifiers to exhibit optimal performance, suitable for the proposed system. Finally, to enlarge the population for which the wheelchair BCI system could benefit for, a SSVEP system for hybrid BCI was designed and tested. These systems provide a non-invasive, practical approach for BCI users in controlling assistive devices such as a virtual wheelchair, in terms of ease of use, adequate speed, and sufficient control accuracy.
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Energetická náročnost pohybu na vozíku u pacientů amputovaných na dolní končetině / Energy expenditure of driving in a wheelchair in people with lower limb amputationNěmeček, Pavel January 2012 (has links)
The aim of this thesis was to determine the effect of driving in a wheelchair and walking on crutches on the energy expenditure and cardiopulmonary system in people with lower limb amputation. For this measurement we used a device Metamax 3B made by Cortex, functioning by measuring the concentration of oxygen and carbon dioxide in the breathing air, and a sporttester made by Polar. On the basis of oxygen consumption is possible to determine an energy expenditure during the activity. Our study was attended by 11 probands (men), patient of long-term hospital in Motol Hospital. Nine probands were amputated from vascular causes, one from the traumatological causes and one from the other causes. Probands rode (or walked) for four minutes back and forth along the corridor thirty meters long. They were instructed to ride (walk) at a speed to fit their needstand to also keep the same pace for a defined period of time. Walking on crutches without prosthesis managed only three of the testing file. During the study, these values were measured: distance traveled, average speed, oxygen consumption (VO2, VO2/kg, VO2 peak), carbon dioxide output (VCO2), respiratory exchange ratio (RER), tidal volume (VT), breathing frequention (BF), minute ventilation (MV), heart rate (HR), energy expenditure and performance. In this work...
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Le fauteuil roulant chez le blessé médullaire, facteur déterminant de l'insertion sociale. État des lieux et effets de la locomotion en dévers sur les astreintes physiologiques / Wheelchair in spinal cord injury, determinant factor of social insertion. Status and impact of locomotion on cross slope on physiological strainsPierret, Benoît 03 December 2012 (has links)
Introduction. Les capacités et les possibilités de déplacement en fauteuil roulant manuel (FRM) sont déterminantes pour l'intégration sociale et professionnelle des usagers. Objectifs. Approfondir la connaissance des contraintes de déplacement en FRM à travers 2 études. La 1ère pour identifier les habitudes et préciser les difficultés des usagers ; la 2nde, induite par les résultats de la 1ère, pour évaluer les effets du dévers, encore méconnus, sur les astreintes cardiaques, énergétiques, musculaires et subjectives. Méthodes. La 1ère étude a été menée par questionnaire complété par 118 sujets paraplégiques en FRM. La 2nde étude, en laboratoire avec 25 hommes paraplégiques, comporte 2 tests : un test d?effort sur ergocycle à bras et un test de propulsion de 300 m et 8 conditions combinant 4 dévers (0, 2, 8 et 12 %) et 2 vitesses (0,97 m.s-1 et une vitesse choisie "de confort"). Résultats. La 1ère étude révèle un environnement peu adapté, avec des moyens de transport et des bâtiments souvent inaccessibles sans aide, et des gènes limitant les sorties des usagers parmi lesquelles figure le dévers. La 2nde étude indique des astreintes cardiaques, énergétiques et musculaires significativement modifiées par le dévers et par la vitesse (p < 0,01). L'astreinte subjective n'est pas modifiée par la vitesse. Des différences entre 0 et 2 % sont faibles mais existent. Un dévers de 12 % est difficilement réalisable. Les équilibres des activités musculaires changent dès 2 % de dévers. Le niveau lésionnel modifie de façon très importante les stratégies de déplacements et les niveaux d'astreintes mesurées ou perçues. Discussion-Conclusion. Les effets du dévers sont perceptibles dès 2 % et sont nets et délétères à 8 %. Ce travail permet de proposer de façon plus argumentée un modèle d'astreintes qui conforte le seuil de dévers fixé réglementairement à 2 % permettant à la grande majorité des usagers de FRM de se déplacer de façon autonome et de rester actifs / Introduction. Displacement capacities and possibilities in manual wheelchair (MWC) are strong determinants of social and occupational integration of MWC users. Objectives. Improve the knowledge of the strains involved by displacement in MWC through 2 studies; the first one to identify habits and difficulties of MWC users. The second one, induced by the results of the first one, has assessed the poorly known cardiac, energetic, muscular and subjective strains of the displacement of MWC users on a cross slope. Methods. The first study was a survey answered by 118 paraplegics habitual MWC users. The second one, a laboratory study conducted with 25 paraplegic men, includes 2 tests: a sub maximal arm-cranking test and a 300 m propulsion test with 8 conditions combining 4 cross slopes (0, 2, 8 et 12%) and 2 velocities (0,97 m.s-1 and a "comfortable" chosen one). Results. The first study shows an adverse environment, with many places unreachable without help and disturbances, like cross slope, which hinders users' displacements. The second study demonstrates the increases of cardiac, energetic, muscular and subjective strains with cross slope. Differencies between 0 and 2% cross slopes are low but quantified. Displacement on a 12% cross slope is very difficult. The balance of muscles activities is changing at 2% cross slope. The injury level makes deep changes in the displacements strategies and in as well perceived as measured strain levels. Discussion-Conclusion. Effects of cross slope are perceived for as low as 2% and onwards values. They are high and deleterious at 8%. This work allows to construct a model of cross slope strains which confirms that the regulatory 2% cross slope limit is well chosen because it allows most MWC users to move without help and remain active
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