Biofeedback for Wheelchair Users
Condition: Spinal Cord Injuries
MeSH terms: Spinal Cord Injuries
Study type: Interventional

Summary: 
      This study will evaluate movement of the arm and forces put through the hand during
      activities performed in a manual wheelchair. The goal of this study is to identify what
      motions and forces are most likely to lead to the development of pain or pathology and
      determine the feasibility of strategies to modify movements and decrease risk.
    

Detailed description: 
      Participants in the study will be asked to participate in the following during the first
      (1st) session:

        1. Physical exam assessing joint motion

        2. Questionnaires asking about shoulder pain

        3. All or a subset of the following activities:

             1. Level wheelchair propulsion for up to 10 minutes

             2. Ramp wheelchair propulsion

             3. Lifting the wheelchair, including into a car (simulated car in therapy area)

             4. Transferring in/out of the wheelchair

             5. Overhead tasks (such as lifting an object off a shelf)

             6. Reaching

      During the next session(s), participants will be asked to participate in all or a subset of
      the activities listed above (3a-3f) and will also be guided through a biofeedback
      intervention. The intervention will consist of visual and/or auditory cues to guide movement
      while performing the tasks. The visual biofeedback will consist of line or shape targets on a
      screen that are the participant's goal to achieve with their movements. The auditory cues
      will be a tone or multiple tones to alert the participant when to move and/or when targets
      have been achieved. During the biofeedback session the study staff may also provide verbal
      cues and feedback.

      The investigators may review the medical records of the participants to obtain information
      about their spinal cord injury, wheelchair and any injury to their muscles, ligaments, bones
      or nerves.

      During all sessions, and prior to performing the activities listed (3a-3f), motion sensors
      will be applied to the skin overlying the participant's sternum (chest), shoulder blade, via
      a plastic cuff on the arm just above the elbow, and wrist using medical grade adhesive tape.
      Sensors that detect muscle activity may also be applied to the skin of the participant's arm.
      Sensors that detect force applied by the participant's arm will also be used.

      Force will be detected using all or a subset of the following tools: exchanging one of the
      wheels on the participant's wheelchair for one of the same size that detects force, having
      the participant wear a glove that detects force, and using a mat that detects force.

      The activities completed while in this study may be photographed or videotaped.
    

Intervention name(s): Biofeedback
Intervention type(s): Other
Intervention description(s): The visual biofeedback will consist of line or shape targets on a screen that the participants will aim to achieve with your movements. The auditory cues will be a tone or multiple tones to alert them when to move and/or when targets have been achieved. During the biofeedback session the study staff may also provide verbal cues and feedback.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science