Effect of rear suspension and speed on seat forces and head accelerations experienced by manual wheelchair riders with spinal cord injury.

Whole-body shocks and vibrations experienced during manual wheelchair use can decrease an individual's comfort, increase the rate of fatigue, result in injury, and consequently limit mobility and community participation. We used a wheelchair-vibration simulator to examine whether the seat reaction forces experienced by wheelchair users were differentially influenced by wheelchair suspension, trunk-muscle innervations, and ground speed. We used wheelchairs instrumented with load cells and accelerometers to determine the forces transmitted from the seat frame and the head accelerations experienced by riders. We determined that self-selected speed, seat force, and head accelerations differed between subjects with and without trunk-muscle innervations and between rigid and suspension wheelchairs. Seat force and head accelerations were greatest in the rigid-frame wheelchair and lowest in the spring-type suspension-frame wheelchairs. Those participants without trunk-muscle innervations preferred slower speeds than those with trunk-muscle innervations. Forward head accelerations were greater in those without than with trunk-muscle innervations. Wheelchair rear-suspension systems may improve wheelchair mobility function in terms of comfort at higher velocity by minimizing the seat forces and head accelerations experienced by the riders, especially those with higher level spinal cord injury and diminished postural control.