RehabMove 2018: MOTOR LEARNING OUTCOMES OF WHEELCHAIR PROPULSION DURING SPINAL CORD INJURY REHABILITATION AND IN EXPERIENCED USERS

PURPOSE: 1. To describe the motor learning outcomes of wheelchair propulsion across 6 weeks of clinical spinal cord injury (SCI) rehabilitation 2. To compare those outcomes between persons at discharge from clinical rehabilitation and experienced community-dwelling wheelchairs users. METHODS: 8 Individuals with a recent SCI performed a submaximal exercise test once-weekly across 6 weeks, starting at the beginning of active rehabilitation. Energy consumption and propulsion kinetics were recorded. In the first and the last week of the 6-week period, participants performed a peak graded exercise test and a 10-item wheelchair skill circuit. 15 experienced individuals with a SCI performed all above-mentioned tests on one occasion. RESULTS: Mechanical efficiency (ME) (6.4->6.2%, p=0.23) and propulsion technique (push frequency 58->56 push/min, p=0.84; contact angle 71->74°, p=0.712; positive work per push 8.3->8.9 J, p=0.30) did not change during the first 6 weeks of active SCI rehabilitation. Peak power output increased (38 W -> 45 W, p=0.01) between the first and the last week. Performance time on wheelchair circuit improved (18.4 -> 16.6 s, p=0.01) and ability score showed a borderline increase (8.4->8.9, p=0.09). No difference in propulsion technique was found between the recent SCI at discharge and experienced group (respectively, push frequency 56 vs. 50 push/min, p=0.57; contact angle 74 vs 78°, p=0.57; positive work 8.9 vs 9.6 J, p=0.65). ME was higher in the recent SCI group (6.1 vs 5.1%, p=0.03). Peak power output (45 vs 59 W, p=0.11), ability score (8.9 vs 9.6, p=0.06) and performance time did not differ between the groups (16.6 vs 15.3 s, p=0.12). CONCLUSION: Recent SCI group did not improve ME and propulsion technique across 6 weeks of active rehabilitation but exhibited an improvement in the peak capacity and wheelchair skill. Between groups comparison provided surprising results as the only significant difference showed higher ME in the recent SCI group.