Mechanical energy and power flow analysis of wheelchair use with different camber settings.

It has been suggested that minimisation of energy cost is one of the primary determinants of wheelchair designs. Wheel camber is one important parameter related to wheelchair design and its angle may affect usability during manual propulsion. However, there is little available literature addressing the effect of wheel camber on the mechanical energy or power flow involved in manual wheelchair propulsion. Twelve normal subjects (mean age, 22.3 years; SD, 1.6 years) participated in this study. A video-tracking system and an instrumented wheel were used to collect 3D kinematic and kinetic data. Wheel camber of 0° and 15° was chosen to examine the difference between mechanical power and power flow of the upper extremity during manual wheelchair propulsion. The work calculated from power flow and the discrepancy between the mechanical work and power flow work of upper extremity had significantly greater values with increased camber. The upper arm had a larger active muscle power compared with that in the forearm and hand segments. While propelling the increased camber, the magnitude of both the proximal and distal joint power and proximal muscle power was increased in all three segments. While the propelling wheel with camber not only needs a greater energy cost but also there is greater energy loss.