Effect of Seat Height and Angle on Wheelchair Foot Propulsion

Study Overview
=================
Brief Summary
-----------------
The purpose of the project is to explore the effect of differences in seat height and seat angle on bilateral foot propulsion using a manual wheelchair. The objectives of the study are to determine whether differences in seat height and seat angle impact: a) propulsion speed; b) knee range of motion used during propulsion; c) effectiveness of foot propulsion gait; and d) perceived difficulty with foot propulsion. A repeated measures designs allows comparison between 5 different seat height conditions and 4 different seat angle conditions to determine whether there are significant differences in outcome, and if so, which conditions provide better outcomes. Participants will propel a customized MWC through a standardized course using each seat configuration; the sequence will be randomized to reduce any learning effects.

Official Title
-----------------
Effect of Seat Height and Angle on Wheelchair Foot Propulsion

Conditions
-----------------
Healthy

Intervention / Treatment
-----------------
* Other: Seat height
* Other: Seat inclination


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: student in College of Rehabilitation Sciences enrolled in Master of Occupational Therapy, Master of Physical Therapy, or Bachelor of Respiratory Therapy program at the University of Manitoba. Able-bodied individuals Exclusion Criteria: Students whose hip width exceeds 21 inches or lower leg length is shorter than 16 inches will be excluded as the test manual wheelchair will not accommodate these dimensions.
Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Interventional Model Description: Within-subjects repeated measures design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LL & 0<br>Wheelchair seat height will be positioned at lower leg length and set inclination will be zero | Other: Seat height<br>* Seat height of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>Other: Seat inclination<br>* Seat inclination of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: LL + 1<br>Wheelchair seat height will be positioned at the participant's leg length plus one inch with an inclination of zero | Other: Seat height<br>* Seat height of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: LL - 1<br>Wheelchair seat height will be positioned at the participant's leg length minus one inch with an inclination of zero | Other: Seat height<br>* Seat height of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: LL - 2<br>Wheelchair seat height will be positioned at the participant's leg length minus two inches with an inclination of zero | Other: Seat height<br>* Seat height of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: LL - 3<br>Wheelchair seat height will be positioned at the participant's leg length minus three inches with an inclination of zero | Other: Seat height<br>* Seat height of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: 3 degrees Inclination<br>Wheelchair seat height will be positioned at the participant's leg length with a forward seat inclination of 3 degrees | Other: Seat inclination<br>* Seat inclination of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: 6 degrees Inclination<br>Wheelchair seat height will be positioned at the participant's leg length with a forward seat inclination of 6 degrees | Other: Seat inclination<br>* Seat inclination of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|
| Experimental: 9 degrees Inclination<br>Wheelchair seat height will be positioned at the participant's leg length with a forward seat inclination of 9 degrees | Other: Seat inclination<br>* Seat inclination of a manual wheelchair will be changed according the different arms specified. The participant will complete a course in the manual wheelchair with each arm.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Propulsion speed | Speed will be determined via video recording. Two outcomes will be determined initial 10m and total test course |  30-60 seconds | 
| Knee range of motion | Xsens sensors and mobile app will be used to determine the positions of the thigh and lower leg and knee joint angle will be obtained from the difference between these positions. |  30-60 seconds | 
| Effectiveness of foot propulsion gait | Evaluated using the Wheelchair Propulsion Test developed by Askari et al. (2013). Simple, valid and reliable measure of propulsion for either upper or lower extremity propulsion techniques. |  30-60 seconds | 
| Perceived difficulty with foot propulsion | Participant will provide subjective evaluations of how difficult they found foot propulsion after each trial, using Perceived Difficulty Questionnaire (Heinrichs et al., 2021). |  30-60 seconds | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Bilateral propulsion, Manual Wheelchair, Foot propulsion