Whole-body kinematics during paddling on kayak ergometer in elite able-bodied athletes : a first step to develop a classification for para-kayak athletes

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Whole-body kinematics during paddling

on kayak ergometer in elite able-bodied

athletes

– a first step to develop a classification for para-kayak athletes

Pascal Zakaria

The Swedish School of Sport and Health Sciences (GIH)

Master thesis, advanced level 156: 2013

Master program in Sport science 2012-2013

Supervisor: Anna Bjerkefors & Olga Tarassova

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Helkroppskinematik under paddling på

ergometer hos elit-kanotister

– ett första steg i utvecklingen av klassificeringen för para-kanotister

Pascal Zakaria

GYMNASTIK- OCH IDROTTSHÖGSKOLAN

Självständigt arbete, avancerad nivå 156: 2013

Masterprogrammet i idrottsvetenskap 2012-2013

Handledare: Anna Bjerkefors & Olga Tarassova

Examinator: Karin Söderlund

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Acknowledgement

I want to thank my supervisor Anna Bjerkefors, which I am always forever, be grateful for. Thank you for your patience, guidance and knowledge all the time through the whole project. I also want to thank Olga Tarassova for her technical support and guidance. Thanks to all

volunteers who made this project possible.

Stockholm January 2014

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Abstract Aim

The purpose of the study was to define three dimensional range of motion for all major joints (wrist, elbow, shoulder, trunk, pelvis, hip, knee, and ankle) in a group of able-bodied elite canoeists during paddling on a kayak ergometer. An additional purpose was to analyze if the range of motion changed with increased intensity and if there were any differences between body sides during paddling on the ergometer.

Method

Ten elite athletes (four women and six men) volunteered for the study (22 ± 3.5 years, 78.3 ± 10.2 kg, 1.79 ± 0.06 m). Three-dimensional kinematic data was recorded using an optoelectronic system and twelve cameras were placed in a circle around the ergometer. Fifty-four reflective markers were attached on the subject and 14 body segments were defined in the model used in the analysis to evaluate range of motion for each joint. Kinematic and force data were collected during paddling on the kayak ergometer at incremental intensities starting at 50 W (“Low”) and increased with 50 W until the athlete was not able to hold the predetermined level

(“Sub-maximal”). The participants were asked to maintain each intensity level as stable as possible during at least 20 kayak cycles, i.e. approximately 60 sec during the lowest intensity level. Finally, a maximal test was performed (“Maximal”). Mean values of 10 stroke cycles were used in the statistics.

Result

The mean range of motion was for shoulder flexion; 3 – 101°, shoulder abduction; 9–53°, shoulder inward/outward rotation; 39–51°, elbow flexion; 13–118°, wrist palmar/dorsiflexion; 9–31°, wrist radial/ulnar deviation; 9–22°, trunk flex/extension; 8 –1°, trunk rotation left/right; 24–24, trunk lateral bending right/left; 7 – 8°, hip flexion 85-116°, knee flexion; 7–56° and foot flexion 64–91°. When intensity increased the range of motion significantly increased in peak joint angle for shoulder flexion, shoulder inward rotation, trunk- , hip-, knee- and foot flexion. In general, there were no significant differences observed between left and right side for maximal and minimal range of motion.

Conclusion

The results from this kinematic study can be used as adequate reference values in the development for an evidence-based classification system for para-canoeists.

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Abstrakt Syfte

Syftet med studien var att undersöka tredimensionell rörelse för samtliga större leder i kroppen (axel, armbåge, handled, bål, bäcken, höft, knä och fotled) i en grupp elitkanotister under paddling på en ergometer. Syftet var också att undersöka om det högsta vinkelvärdet i vardera rörelseriktningen förändrades med ökad intensitet samt om det fanns någon asymmetri mellan kroppshalvorna i rörelseutslag under paddling på ergometern.

Metod

Tio svenska elitkanotister (fyra kvinnor och sex män) deltog frivilligt i denna studie (22 ± 3.5 år, 78.3 ± 10.2 kg, 1.79 ± 0.06 m). Tredimensionell rörelsekinematik registrerades med hjälp av ett optoelektroniskt system och tolv kameror placerades i en cirkel runt kajakergometern.

Femtiofyra reflexiva markörer placerades på kroppen och 14 kroppssegment definierades i modellen och användes i analysen för att utvärdera rörelseomfånget i respektive led. Kinematik och kraftdata samlades in under paddling på ergometern vid olika intensitetsnivåer med start på 50 W (”Låg”) och ökade med 50 W till dess att idrottaren inte kunde hålla den förutbestämda nivån (”Sub-maximal”). Varje forskningsperson uppmanades att bibehålla varje

intensitetsnivå så precist som möjligt under minst 20 paddlingscykler, vilket var cirka 60 sekunder på den lägsta intensitetsnivån. Därefter genomfördes ett maximalt test (Maximal). Medelvärdet av 10 paddelcykler användes i statistiken.

Resultat

Medelvärdet för rörelseomfånget var för skulderflexion; 3 – 101°, skulderabduktion; 9–53°, skulderinåtrotation/utåtrotation; 39–51°, armbågsflexion; 13–118°, palmar/dorsalflexion i handleden; 9–31°, radial/ulnar deviation i handleden; 9–22°, bålflexion/extension; 8 –1°, bålrotation vänster/höger; 24–24, bålböjning höger/vänster; 7 – 8°, höftflexion 85-116°, knäflexion; 7–56° och plantar/dorsalflexion i foten 64–91°. När intensiteten ökade, ökade rörelseutslaget signifikant i skulderflexion, skulderinåtrotation, bål-, höft-, knä- och fotflektion. Generellt fanns det ingen signifikant skillnad mellan sidorna vad gäller rörelseutslag.

Slutsats

Resultaten från denna studie kan användas som adekvata referensvärden i utvecklandet av den evidensbaserade klassificeringen av para-kanotister.

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Table of Contents

1. Introduction ... 1

1.1 Paralympics ... 1

1.2 Kayaking ... 2

1.3 Kinematic and kinetics ... 3

1.4 Purpose ... 4 1.5 Research questions ... 4 2. Methods... 4 2.1 Type of method ... 4 2.2 Selection ... 4 2.3 Subjects ... 5 2.4 Ethical aspects ... 5 2.5 Equipment ... 5 2.6 Test procedure ... 6

2.7 Reliability and validity ... 7

2.8 Data processing………..8 2.9 Statistics ... 8 3. Result ... 9 3.1 Range of motion ... 9 3.2 Power ... 17 3.3 Stroke rate ... 18 4. Discussion ... 18 4.1 Range of motion...18 4.2 Stroke frequency ... 19 4.3 Subjects ... 20 4.4 Conclusion ... 20 4.5 Limitations ... 20 5. References ... 21 6. Appendix………24

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1. Introduction

In December 2010, added International Paralympic Committee (IPC) canoeing as a new sport to the Paralympics in 2016. The International Canoe Federation (ICF) has therefore initiated a project aimed to evaluate, develop and present a proposal to the IPC relating to a validated and modified classification system for para-canoiest (athletes with physical impairments). The classification system used today for canoeist with disability is divided into three groups,

canoeists with full or partly function in the arms, but with reduced function in the trunk and legs (A), canoeists with function in the arms and trunk, but with reduced function in legs (TA) and finally canoeists with function in the arms and trunk, and partial function in the legs (LTA). The new proposal will contain of an improved assessment criteria for eligibility and clear definition between the three classes: A, TA, and LTA.

This master study is the first part of this ongoing project aiming to evaluate whole-body kinematics during kayaking in able-bodied elite athletes. The range of motion required for the able-bodied group will serve as a basis for class division for the para-canoe group. To be eligible to participate as a para-canoeist on national or international competition level it is required to have at least 10 points less than the total maximal score. Thus, the reference values defined as “normal” became crucial when classifying the athletes. For this reason, the whole-body

kinematic analysis will be conducted in a group of elite able-bodied athletes, in order to identify data that could serve as “reference values” assessed during sport-specific circumstances.

Moreover, in the new protocol for classification the aim is to additionally include tests of shoulder rotation, wrist deviation and tests of trunk range of motion as these joint angles have previously been shown to be important parameters during kayaking (McKean & Burkett 2010; Fleming et al. 2012; Michael et al. 2012).

1.1 Paralympics

The Paralympic game is a major international multi-sport event where athletes with a disability compete in different sports. Functional barriers are diverse and may include athletes with

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amputations, spinal cord injury (SCI), visual impairment, etc. Paralympics held both winter and summer games and there are a total of 25 licensed Paralympic Sports (www.paralympic.org). Because there are so many athletes with different functional abilities, athletes are classified into different categories. The reason for this is to make it possible for people with similar functional ability to compete against each other. In recent years, IPC has highlighted the importance of an evidence based classification system for para-athletes (Tweedy & Vanlandewijck 2011). The development and evaluation work has begun in areas such as wheelchair sports, running and Nordic skiing (Altmann, Limbeek, Vanlandewijck & Keijsers 2013; Vanlandewijck, Verellen & Tweedy 2011; Pernot, Lannem, Geers, Ruijters, Bloemendal & Seelen 2011; Beckman & Tweedy 2009).

1.2 Kayaking

Kayaking was introduced as an Olympic sport in 1936 with the distances 1 000 and 10 000 m for able-bodied athletes. In recent years, shorter distances have been included. The shortest distance, 200 m sprint, was introduced for both men and women during the 2012 Olympic Games.

Improvements in materials and design of the kayaks, the introduction of the wing paddle in the 80s and shorter race distances have remarkably decreased the racing time (Michaels, Smith & Rooney 2009). Other factors affecting the performance are the physical status of the kayaker and the efficiency of the kayak technique (c.f. review by McDonell, Patria, Hume & Nolte 2013). During Paralympics 2016, when kayaking for men and women with disabilities will be introduced, the competitions will be performed at the 200 m sprint distance.

Before kayaking was introduced as a Paralympic sport, open-sea kayaking as a leisure activity has been shown to be a suitable and appreciated activity for persons with disability (Grigorenko, Bjerkefors, Rosdahl, Hultling, Alm & Thorstensson 2004). Kayaking is performed in sitting, which is necessary prerequisite for people with impaired function in the trunk and legs. With special arrangement to make the kayak suitable, such as special seats, the athletes are able to perform the paddling movement without losing their balance. When kayaking is performed on regular basis, improvements in postural stability, functional performance and upper body

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strength have been shown in people with SCI (Bjerkefors, Jansson & Thorstensson 2006; Bjerkefors & Thorstensson 2006; Bjerkefors, Carpenter & Thorstensson 2007).

1.3 Kinematic and kinetics

The paddling movement is complex with alternating 3D upper-body movement during the pull, lift and push-phase (McDonell et al. 2013) and it involves most of the upper body musculatures (Trevithick, Ginn, Halaki & Balnave 2007). The requirements for balance control are also high due to the complex movement, the interplay between reaction forces in different directions and the construction of the kayak. In able-bodied athletes the paddling movement have partly been described, although no study has yet evaluated the whole body range of motion. Previous studies have described the kinematic and kinetic performance during kayaking and the assessment have been conducted under different conditions; such as indoor on kayak ergometer (Wassinger, Myers, Sell, Oyama, Rubenstein & Lephart 2011; Fleming, Donne & Fletcher 2012; Michael et al. 2009; Michael, Rooney & Smith 2012) or in a pool (Begon, Lacouturem & Colloud 2008), or outdoor during white–water paddling (i.e. kayaking on whitewater rivers) (Wassinger 2007) or flat water paddling (Plagenhof 1979; Mann & Kearney 1980; Kendal & Sanders, 1992; Sanders & Kendal 1992). The biomechanical assessments have been made either in two dimensions (2D) (Mann & Kearney 1980; Fleming et al. 2012) or in 3D (Wassinger et al. 2011; Fleming et al. 2012; Michael et al. 2009, 2012).

The study by Wassinger (2011) did not primarily analyse the kinematics of the upper body movement, but investigated where injury can occur during kayaking. They concluded that the highest prevalence of injury occur when the shoulder joint where in peak flexion in combination with internal rotation and shoulder adduction when subacromial structures may be mechanically impinged. The 3D kinematic analysis made by Fleming et al. (2012) revealed that overhead arm movements accounted for approximately 40 % of the stroke cycle, the elbow angle at stroke cycle onset was 144° and the maximal elbow angle was 151° during the stroke. The study by Michael et al. (2012) examined ten elite canoeists during paddling on a kayak ergometer and they compared and analysed the effect of paddle angle in 3D, paddle force, and timing during the paddling movement and the mechanical effects between right and left side. The study did not

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include range of motion evaluation but showed differences in mechanical effect (power) and force between left and right side. All participants were right-handed and significant greater values were shown on the right side. Recently, investigators have also paid attention to the lower body movement during kayaking as the push and pull forces on the foot bar contributes to the power output (Nilsson & Rosdahl 2013).

1.4 Purpose

The purpose of the study is to define the 3D range of motion for all major joints (wrist, elbow, shoulder, trunk, pelvis, hip, knee and ankle) in a group of elite able-bodied kayakers during paddling on kayak ergometer.

1.5 Research questions

• Does the range of motion and stroke frequency change with intensity?

• Are there any asymmetries between left and right side in the means of the joint range of motion during paddling on the ergometer?

2. Methods

2.1 Type of method

This is a quantitative, descriptive study conducted in a laboratory environment and set-up.

2.2 Selection

Elite kayakers, active in Sweden, were informed about the study through email sent by the sports manager Anna Karlsson at the Swedish Canoe Federation. Athletes that showed the interest in participating in the study were asked to contact the principal investigator for the project. The inclusion criteria for the study were that the participants had to be female/male active kayakers competing on international level, over 17 years old and be in good health. Therefore, an

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additional email with information if they were considered to meet the inclusion criteria selected was sent to the athletes agreed to participate.

2.3 Subjects

Ten elite athletes (four women and six men) volunteered for the study (22 ± 3.5 years, 78.3 ± 10.2 kg, 1.79 ± 0.06 m). The frequency of participating in training was on average 6.9 ± 1.7 sessions per week. The total time for exercising per week was on average 15.4 ± 3.9 hours. In addition to kayaking, exercises such as strength, fitness and running were performed by the athletes at different levels of intensity. All participants were informed with oral and written information regarding the study’s purpose and signed their consent form to participate in the study prior to the testing. Subjects confirmed that they were healthy and had no current illness or injury that could affect their kayaking performance. Ethical approval for the study was granted from the Regional Ethical Review Board in Stockholm (ref: 2013/1041-31/3).

2.4 Ethical aspects

Participants were informed (in written form and orally) that the participation for this study was voluntary, and could be interrupted at any time without giving any reason. All data will be unidentified by a code and will be kept in a secured place (locked cabinets and password-protected electronic data) in the principal investigator´s office or laboratory. During all tests subjects should be healthy with no on-going disease or injury at the time of testing. The risks of the study are minor. However, participants will be exposed to a physical stress during the testing that can slightly affect muscles soreness. Participants should not have been training intensively before the test date as this can create muscle fatigue that affects the participant’s typical range of motion.

2.5 Equipment

A paddling kayak ergometer was used in the study. The resistances on the ergometer could be adjusted by regulating the air intake on the flywheel from one (lightest) to ten (heaviest). For this study the resistance was set at 8 for females and 10 for males, which corresponds to their

exercise intensity. Three-dimensional kinematic data was recorded using an optoelectronic system (Oqus, Qualisys AB, Sweden) at a sampling frequency of 150 Hz. The set-up included

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twelve cameras placed in a circle with a radius of approximately three meters around the kayak ergometer. Fifty-four reflective markers with a diameter of 12 mm were attached on the body and 18 markers were placed on the kayak paddle shaft and on the ergometer (Figure 1). The same person attached all markers for each subjects and tests. The markers were attached directly on anatomical landmarks in order to construct whole body model consisting of 14 segments.

Piezoelectric force transducers (Type 9311B, Kistler Instruments AG, Switzerland) were used to register the force in the paddle shaft at a sampling frequency of 1500 Hz. The transducers were connected to an amplifier (Type 5073, Kistler Instruments AG, Switzerland) and signals were A/D converted (Kistler Instruments AG, Switzerland).

2.6 Test procedure

All tests were performed at the Laboratory for Biomechanics and Motor Control at the Swedish School of Sport and Health Sciences (GIH) in Stockholm, during April to May 2013. Before the test, subjects were introduced to the test procedure, familiarized with the ergometer and

performed 5 minutes of warm-up. Thereafter the participants were asked to paddle at incremental intensities (starting from 50 W defined as “Low”) with a 3-minute break between all tests

allowed. The participants were asked to maintain each intensity level as stable as possible during at least 20 kayak cycles, i.e. approximately 60 sec during the lowest intensity level. After the test at the lowest intensity was performed, the intensity was then increased with 50 W until the

“Sub-Figure 1. Whole body model consisting of 14 segments.

The markers were attached at the following positions: for the a)

hand and arm segments: 8 markers (on each left and right side)

were attached on the wrist and hand, forearm, lateral and medial part of the elbow and upper arm, b) trunk segment: 6 markers were placed in a diamond shape, 3 over the spine at C7, T5 and T12 level and one on the left and right acromion, and one marker attached on the centre of the sternum, c) pelvis segment: 4 markers were attached on the left and right spinae iliaca anterior superior (SIAS) and on the left and right spinae iliaca posterior superior (SIPS), d) leg and foot segments: 14 markers were attached on the thigh (femur), lateral and medial part of the knee joint, the lower leg and lateral and medial part of the ankle and foot. In addition; 18 markers were attached along the kayak ergometer, paddle and on the both edges of each force transducer.

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maximal” level, i.e. the highest level that the athlete could maintain stable during 20 kayak cycles. Then the participants were asked to do the maximal test defined as “Maximal”. Subjects were instructed and verbally encouraged to execute 20 all out maximal cycles after slowly have increased the intensity during 15 kayak cycles up to maximal intensity. Kinematic and kinetic data were collected for each test.

2.7 Reliability and validity

The present study uses quantitative measures to define reference values on joint range of motion in able-bodied elite kayak athletes. No tests of reliability were made in this study and therefore care was taken to test athletes who had been practicing kayaking for many years. To minimize the variability within each subject only elite able bodied kayak athletes with long experience of the paddling movement were recruited. Also, all subjects were competing on international level and they were all familiar to exercise on high intensities on the kayak ergometer. We did not expect any differences in joint angular movement between male and females and therefore athletes from both gender participated. However, differences in power output were expected.

It is known that for valid evaluation of kayak performance, testing should be done in a sport-specific environment. However, in some cases, a number of environmental factors may disturb a simultaneous collection of kinematic and kinetic data, for example during on water paddling. Therefore, in this study, measurements were performed on a kayak ergometer in a laboratory environment to avoid external interference from weather conditions.

3D motion measurements are always related to some errors caused by this skin movement artifact during motion as well as system error and marker noise. To minimize the error markers have been applied to anatomical landmarks (e.g. the lateral/medial elbow

epicondyle or lateral/medial malleolus to minimize the skin movement). To minimize the sensor noise 12 cameras have been used in this study so all of the markers will be visual during the capture. The volume where the tests have been performed has also been calibrated frequently throughout the tests. A low-pass Butterworth filter with a cutoff frequency of 7.0 Hz has also been used during the data analysis to minimize that the signal was robust and not influenced by fluctuations in signal.

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2.8 Data processing

Analysis and calculations of the kinematics and kinetics were performed in Visual3D software (version 4, C-Motion, Inc., USA) and in MATLAB (The MathWorks, Inc., USA). Shoulder joint was defined as a functional joint using the elbow, shoulder and trunk markers. For the shoulder joint, abduction/adduction and inward/outward rotation were also calculated. Trunk flexion and extension were defined as trunk rotation about the medio-lateral axis in the global coordinate system. Trunk rotation (roll) and lateral flexion (pitch) were defined as trunk rotation about the upward-downward axis and the anterior-posterior axis, respectively. Hip joint was defined as a functional joint using the markers on pelvis and thigh segments. Total range of motion, maximal and minimal peak flexion and extension, were calculated for the the wrist, elbow, shoulder, trunk, hip, knee and ankle joints. Additionally, the total range of motion was also calculated for the shoulder joints; peak abduction/adduction and inward/outward rotation, and for the trunk; peak trunk rotation and lateral trunk flexion. Kinematic were also used to calculate stroke cycle and stroke rate. All marker trajectories were smoothed with a second-order, bi-directional, low-pass Butterworth filter with a cutoff frequency of 7.0 Hz. For all calculations, only the final 10 stroke cycles for each level were used. All signals were synchronized.

2.9 Statistics

The statistical analyses were carried out in STATISTICA 11.0 (StatSoft, USA). Shapiro-Wilk´s W test was applied to examine normality in the distribution of the data. Descriptive statistics was used to present all research variables as mean values and standard deviations (SD). To detect differences during paddling, maximal and minimal joint angle within range of motion values for each joint were analysed using a two way analysis of variance (ANOVA), with two within subject factors: intensity (low, sub-maximal and maximal) and body side (left and right). Additionally, paired Student T-test was performed to compare the peak values of trunk flexion/extension joint angle between intensities. Significance level was set at p ≤ 0.05.

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3. Result

3.1 Range of motion

The peak joint angle movement within range of motion for all tested joints is presented for maximal values in Table 1 and for minimal values in Table 2.

Table 1. Mean values (and standard deviations) of maximal peak range of motion presented as angular displacement

Maximal angular displacement (°) Low Sub-maximal Maximal Left Right Left Right Left Right Shoulder Flexion 90.0 ± 11.9 91.7 ± 9.7 100.9 ± 10.0 101.3 ± 9.9 99.0 ± 12.8 100.3 ± 12.9

Abduction 52.3 ± 9.0 53.3 ± 7.2 47.8 ± 8.7 44.0 ± 9.2 49.1 ± 7.5 49.1 ± 5.6

Outward rotation 50.5 ± 16.6 53.3 ± 17.6 39.8 ± 15.1 43.6 ± 19.0 28.1 ± 13.8 34.3 ± 19.5

Elbow Flexion 118.0 ± 17.1 112 ± 8.4 113.3 ± 22.9 111.1 ± 11.0 102.6 ± 23.8 106.0 ± 13.7

Wrist Palmar flexion 9.3. ± 10.6 5.1 ± 9.4 8.7 ± 10.4 7.7 ± 6.9 2.4 ± 10.4 3.1 ± 5.5

Radial deviation 3.5 ± 4.9 2.8 ± 7.0 8.4 ± 6.4 7.5 ± 5.4 9.0 ± 7.0 6.9 ± 5.8

Trunk Flexion 4.1 ± 3.0 7.9 ± 2.7 8.3 ± 5.2

Rotation to the left 20.5 ± 3.6 20.9 ± 3.3 23.6 ± 6.1 23.5 ± 5.9 19.9 ± 7.5 22.0 ± 6.6

Lateral bending (right) 5.9 ± 4.5 6.1 ± 4.6 6.0 ± 4.2 6.0 ± 4.2 6.8 ± 4.3 7.4 ± 4.0

Hip Flexion 109.1 ± 3.0 107.3 ± 4.3 116.1 ± 3.1 114.2 ± 3.6 115.1 ± 5.3 112.7 ± 6.6

Knee Flexion 48.1 ± 4.1 45.8 ± 2.3 54.2 ± 4.4 50.4 ± 3.6 55.7 ± 4.0 52.1 ± 2.2

Foot Plantar flexion* 82.0 ± 6.0 80.2 ± 4.9 90.6 ± 7.3 88.3 ± 7.4 91.2 ± 4.9 89.2 ± 7.8

Note: *90 degree flexion indicates when the foot is in neutral position during standing.

Table 2. Mean values (and standard deviations) of minimal peak range of motion presented as angular displacement

Minimal angular displacement (°) Low Sub-maximal Maximal Left Right Left Right Left Right Shoulder Flexion 3.3 ± 13.6 7.5 ± 11.3 11.0 ± 12.4 17.6 ± 9.8 19.4 ± 14.2 21.5 ± 12.0

Abduction 10.0 ± 6.5 9.9 ± 4.0 9.3 ± 6.0 7.9 ± 2.2 13.0 ± 7.2 9.8 ± 3.2

Inward rotation -14.7 ± 11.0 -14.9 ± 20.1 -34.7 ± 14.9 -35.7 ± 22.4 -39.3 ± 14.2 -40.6 ± 21.2

Elbow Flexion 17.8 ± 8.2 20.7 ± 9.2 18.6 ± 7.8 21.4 ± 8.6 12.6 ± 24.5 21.1 ± 9.0

Wrist Dorsal flexion -20.7 ± 7.1 -25.1 ± 10.4 -27.3 ± 7.6 -29.1 ± 12.0 -30.8 ± 8.5 -31.2 ± 10.9

Ulnar deviation -22.1 ± 4.8 -22.1 ± 8.3 -22.4 ± 4.5 -24.5 ± 6.6 -19.1 ± 5.9 -24.2 ± 5.7

Trunk Flexion/extension -0.8 ± 3.3 1.00 ± 4.8 1.8 ± 7.5

Rotation to the right -20.4 ± 3.4 -19.7 ± 4.2 -23.6 ± 6.0 -23.4 ± 6.0 -23.2 ± 7.4 -23.4 ± 7.4

Lateral bending (left) -5.5 ± 3.3 -5.1 ± 3.0 -6.1 ± 2.4 -6.0 ± 2.4 -8.4 ± 3.1 -8.6 ± 3.0

Hip Flexion 89.1 ± 7.8 87.3 ± 9.2 85.3 ± 5.7 82.8 ± 7.2 87.8 ± 7.0 83.8 ± 7.2

Knee Flexion 15.2 ± 10.9 13.7 ± 11.9 7.0 ± 4.8 4.4 ± 6.7 11.4 ± 7.5 5.1 ± 6.9

Foot Plantar flexion 66.9 ± 7.6 65.5 ± 9.0 63.6 ± 5.1 62.3 ± 8.5 63.5 ± 7.1 60.5 ± 7.8

Note: *90 degree flexion indicates when the foot is in neutral position during standing.

In Figure 1 the average values (and standard deviations) from left and right side angular displacement (y-axis) curves are presented, for shoulder flexion, abduction and rotation (a), elbow flexion (b), wrist flexion and deviation (c), hip flexion (d), knee flexion (e), foot flexion (f), and trunk rotation, bending and flexion. The data are presented during kayaking at three

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different intensities; i.e. Low (black line), Sub-maximal (red line) and Maximal (green line). Data obtained from the left body side is presented in the left column, and data from the right side is presented in the right column. The data is normalized during stroke cycle (x-axis) and 0 % represents the beginning of the pull phase on the ipsilateral side, i.e. start of the left pull phase for the left side, and start of the right pull phase for the right side.100 % present represents the end of the pull phase on the contralateral side, i.e. end of the right pull phase for the left side, and end of the left pull phase for the right side.

a. 0 20 40 60 80 100 0 20 40 60 80 100

Left shoulder Flexion

An g u la r d is p la ce m en t (d eg )

Normalised kayak stroke 0 - 100 %

Low SubMax Max 0 20 40 60 80 100 0 20 40 60 80 100

Right shoulder flexion

Normalaised kayak stroke 0 - 100 %

Low SubMax Max 0 20 40 60 80 100 0 20 40 60

Left shoulder abduktion

A n g u la r d is p la ce m en t ( d eg )

(Normalised kayak stroke 0 - 100 %)

Low SubMax Max 0 20 40 60 80 100 0 20 40 60 80 100 An g u la r d is p la ce m en t (d eg )

Right shoulder abduction

Low SubMax Max

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0 20 40 60 80 100 -60 -40 -20 0 20 40 60 80

Left shoulder rotation

Low SubMax Max 0 20 40 60 80 100 -60 -40 -20 0 20 40 60 80

Right shoulder rotation

Low SubMax Max

Note: For shoulder rotation, negative values indicate inward rotation.

b. 0 20 40 60 80 100 0 20 40 60 80 100 120

140 Left elbow flexion

Low SubMax Max 0 20 40 60 80 100 0 20 40 60 80 100 120 140

Right elbow flexion

Low SubMax Max c.. 0 20 40 60 80 100 -40 -20 0

20 Left wrist flexion

An g u lar d isp lacem en t (d eg )

Low SubMax Max 0 20 40 60 80 100 -40 -20 0 20

Right wrist flexion

Low SubMax Max

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0 20 40 60 80 100

-20 0 20

Left wrist deviation

An g u la r dis p la ce m e n t ( d e g )

Normalised kayak stroke 0 -100 %

Low SubMax Max 0 20 40 60 80 100 -20 0

20Righ Wrist deviation

Low SubMax Max

Note: For wrist deviation, negative values indicate ulnar deviation.

d. 0 20 40 60 80 100 60 80 100 120

Left hip flexion

Low SubMax Max 0 20 40 60 80 100 60 80 100 120

Right hip flexion

Low SubMax Max e. 0 20 40 60 80 100 0 20 40 60

80 Left knee flexion

Low SubMax Max 0 20 40 60 80 100 0 20 40 60

80 Right knee flexion

Low SubMax Max

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f.

0 20 40 60 80 100

60 80

100 Left foot flexion

Y Ax is T itl e X Axis Title Low SubMax Max 0 20 40 60 80 100 60 80

100 Right foot flexion

Low SubMax Max g. 0 20 40 60 80 100 -40 -20 0 20 40

Left trunk rotation

Low SubMax Max 0 20 40 60 80 100 -40 -20 0 20 40

Right trunk rotation

Low SubMax Max

Note: For left and right trunk rotation, negative values indicate trunk rotation to the right.

0 20 40 60 80 100

-20 0 20

Left trunk bending

Low SubMax Max 0 20 40 60 80 100 -20 0

20 Right trunk bending

Low SubMax Max

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0 20 40 60 80 100 0 20 Trunkt flexion An g u la r d is p la ce m en t (d eg )

Low SubMax Max

Figure 1a-g. The average values (and standard deviations) from left and right side range of motion data a) shoulder flexion, abduction and inward

and outward rotation, b) elbow flexion, c) wrist flexion and deviation, d) hip flexion, e) knee flexion, f) foot plantar flexion, g) trunk rotation, lateral bending and flexion, are presented during kayaking at three different intensities; i.e. Low (black line), Sub-maximal (red line) and Maximal (green line).

The mean range of motion was for shoulder flexion; 3 – 101°, shoulder abduction; 9 – 53°, shoulder inward/outward rotation; 39 – 51°, elbow flexion; 13 – 118°, wrist palmar/dorsiflexion; 9 – 31°, wrist radial/ulnar deviation; 9 – 22°, trunk flex/extension; 8 – 1°, trunk rotation

left/right; 24 – 24, trunk lateral bending right/left; 7 – 8°, hip flexion 85 – 116°, knee flexion; 7 – 56° and foot flexion 64 – 91°. In Figure 2 mean values (and standard deviations) are presented of peak maximal and minimal range of motion during kayaking. The range of motion is

presented for the left side for shoulder, elbow, wrist, trunk, hip, knee and ankle joint on the left side. The highest group mean value for each joint was taken independent of intensity.

-‐80 -‐60 -‐40 -‐20 0 20 40 60 80 100 120 140 Shoulder

Flex/Ext Shoulder Abd/Add Shoulder Rotation Ext/In

Elbow

Flex/Ext Palm/DorsWrist Deviation Wrist Rad/Uln

Trunk Flex/Ext Trunk Rotation Left/Right

Trunk Bending Hip Flexion Knee Flexion Foot Flexion

A ng ul ar d is pl ac em en t (de gr ee s)

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Figure 2 Mean values (and standard deviations) are presented of peak maximal and minimal range of motion during kayaking.

Differences between left and right side for peak maximal range of motion

In general, there were no significant differences observed between left and right side for

maximal range of motion data for the shoulder (flexion, abduction and rotation), elbow (flexion), wrist (flexion and deviation), trunk (lateral bending and rotation), hip (flexion) and foot

(flexion). The only significant difference observed between left and right side was for peak maximal knee flexion (p = 0.028, F= 7.22).

Differences between intensity for peak maximal range of motion

Shoulder

A significant main effect of intensity (i.e. irrespective of the body side) was found for shoulder flexion (p < 0.001, F = 14.95) and shoulder rotation (p < 0.001, F= 20.09). For shoulder abduction, no differences in maximal peak of range of motion were seen between either

intensities or body side. For shoulder flexion, results showed significantly lower peak values at “Low” intensity compared to “Sub-maximal” (p < 0.001) and “Maximal” intensity (p < 0.001). Range of motion for shoulder outward rotation decreased with intensity. Peak values at “Low” intensity were significantly higher than at “Sub-maximal” and “Maximal” (p = 0.017 and p < 0.001, respectively). Significantly higher values at “Sub-maximal” compared to “Maximal” intensity (p = 0.018) were also found.

Elbow

For elbow flexion, there was a main effect of intensity (p = 0.033, F= 4.24), with decreased maximal peak observed at “Low” compared to “Maximal” intensity (p = 0.032).

Wrist

No significant differences were seen for palmar flexion. For wrist radial deviation there was a main effect of intensity (p < 0.001, F = 16.17) and significantly higher (p < 0.001) maximal peak were shown at “Sub-maximal” and “Maximal” intensity compared to “Low” intensity.

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Trunk

Larger trunk flexion was shown between “Low” and “Sub-maximal” intensity (p = 0.006) and between “Low” and “Maximal” intensity (p = 0.003). No significant differences between either intensities or body sides were seen for trunk rotation and trunk lateral bending.

Hip, knee and foot

A significant main effect of intensity were found for hip flexion (p = 0.004, F = 8.10), knee flexion (p < 0.001, F = 22.59) and foot flexion (p < 0.001, F = 18.96). For hip, knee and foot flexion maximal peak range of motion increased with intensity, shown between “Low” and “Sub-maximal” (p = 0.005, p < 0.001 and p < 0.001, respectively), and between “Low” and “Maximal” intensity (p = 0.018, p < 0.001 and p < 0.001, respectively). No differences were observed between “Sub-maximal” and “Maximal” intensity for lower limb segments.

Differences between left and right side for peak minimal range of motion

In general, there were no significant differences observed between left and right side for minimal range of motion for shoulder (flexion, abduction and rotation), elbow (flexion), wrist (flexion and deviation), trunk (lateral bending and rotation), hip (flexion) and foot (flexion) segment. The only difference between left and right side was observed for minimal peak of knee flexion (p = 0.049, F = 5.40).

Differences between intensity in peak minimal range of motion

Shoulder

For shoulder flexion there was a main effect of intensity (p < 0.001, F =23.65) with a significant difference between “Low” and “Sub-maximal” (p = 0.003), “Low” and “Maximal” (p < 0.001) and between “Sub-maximal” and “Maximal” intensity (p = 0.034). A main effect of intensity were seen for shoulder abduction (p = 0.031, F =4.33), and a minimal peak was lower at “Sub-maximal” compared to “Maximal intensity” (p = 0.025). For shoulder rotation intensity main effect was observed (p < 0.001, F =101.45). The internal rotation increased with intensity; minimal peak was significantly (p < 0.001) higher at both “Sub-maximal and “Maximal” intensity compared to “Low”.

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Elbow

No significant differences were seen for elbow flexion. Wrist

For wrist extension/flexion a main effect of intensity (p < 0.001, F value=12.90) was shown. The wrist flexion increased with intensity and higher minimal peak was seen at “Sub-maximal” (p > 0.013) and “Maximal” intensity (p < 0.001) compared to “Low”. For wrist deviation there were a significant interaction of intensity and body side (p = 0.022, F = 4.91). At “Maximal” intensity a higher minimal peak was shown for right wrist compared to left body side (p = 0.005).

Trunk

No significant differences were observed for trunk extension movement and trunk rotation. For trunk lateral bending there was a main effect of intensity (p = 0.009, F = 6.37). Larger trunk bending movement during increased intensity was seen from “Low” to “Maximal” (p = 0.009). Hip, knee and foot

No significant differences were seen for hip movement. For knee flexion there was an interaction of intensity and body side effect (p = 0.042, F = 3.90). For the left knee, the minimal peak at “Sub-maximal” intensity were lower than at “Low” (p < 0.001) and at “Maximal” (p = 0.028) intensities. However, for the right knee peak values at “Low” intensity were the lowest compared to “Sub-maximal” (p < 0.001) and “Maximal” (p < 0.001) intensity. Differences in minimal peak flexion between left and right knee were found only at “Maximal” intensity (p = 0.02). A main effect was seen for foot movement (p = 0.003, F = 8.35) with increased plantar flexion at higher intensities observed from “Low” to “Sub-maximal” intensity (p = 0.021) and from “Low” to “Maximal” intensity (p = 0.036).

3.2 Power

The group average maximal power output (W) during the “Maximal test” was 402.4 ± 115.9 W measured from the flywheel on kayak ergometer. The “Sub-maximal” intensity level for the group were as followed: 200W (n=2), 250W (n=2), 300W (n=3), 350W (n=2), and 400W (n=1).

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3.3 Stroke frequency

The frequency at the “Low” intensity was 62.03 ± 6.4 strokes per min, 109.32 ± 8.2 for “Sub-maximal”, and 135.32 ± 25.9 at “Maximal” intensity. The stroke rate increased significantly with work intensity observed between “Low” and “Sub-maximal” intensity (p < 0.001), “Low” and “Maximal” intensity (p < 0.001), and ”Sub-maximal” and “Maximal” intensity (p = 0.016).

4. Discussion

The purpose of this study was to analyze three-dimensional movements of all major joints during paddling on the kayak ergometer in international elite active canoeists. Peak joint angles were calculated in order to examine the total range of motion. An additional purpose was to analyze if the range of motion changed with increased intensity and if there were any differences between body sides during paddling on the ergometer.

4.1 Range of motion

Results showed greater angular movement in shoulder flexion, shoulder inward rotation, wrist dorsiflexion and radial deviation, trunk flexion, trunk downward bending, hip flexion, knee flexion and foot dorsiflexion during increased intensity. Simultaneous increases in shoulder, trunk and hip flexion may allow the paddle shaft to be placed in a more forward position. These changes in angular range of motion support the findings from previous studies that have reported correlations between range of motion and performance indicating that the ability to insert the paddle blade in a far forward position (Brown, Lauder & Dyson 2011) with a shorter backward movement before the paddle blade leaves the water (Kendal & Sanders 1992) lead to improved performance.

To optimize performance the paddling movement should be as symmetric as possible. In general, there were no differences between left and right sides in this group of athletes. To our knowledge there are no studies explaining the impact of body side differences on paddling performance in relation to angular range of motion during paddling. However, results from previous study (Michaels et al. 2012) showed side differences in mechanical efficiency during kayaking on ergometer. The authors suggested that the larger propulsion work on the right side was due to the fact that all participants were right handed.

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The range of motion for all joints calculated in this study can be used as accurate reference values in the development of an evidence-based classification system for kayakers. According to ICF Paracanoe Classification Guidelines, it is assumed that the para-kayaker should have full range of motion, i.e. 100 % of functional range of motion in all tested joints. Thus, the scale based on accurate reference values calculated during actual paddling movement is crucial when classifying the athletes. Moreover, it has previously been shown that shoulder rotation and trunk/pelvic range of motion are important during kayaking (McKean & Burkett 2010; Michaels et al. 2012). Therefore, these additional joint angles were calculated in this study in order to be included in the new evidenced based protocol for classification.

If possible, the evaluation of performance should be done in a sport-specific environment where the activity is usually performed. In this study, we decided to do the measurements on a kayak ergometer. From a biomechanical point of view a major difference between paddling on the ergometer compared to on water paddling is primarily seen in the lateral stability because the ergometer rests on a solid surface (Bjerkefors, Carpenter & Thorstensson 2007). Another

disparity is that the paddle shaft on the ergometer is attached to the ropes which rotate the

flywheel whereas during on water paddling the kayaker uses a paddle for propulsion and balance corrections. We can only speculate whether the joint range of motion will differ depending on testing environment; water vs. kayak ergometer. Trunk movement might be larger, especially in lateral direction, if the athletes perform the test on an unstable surface such as on water. Or it could be the opposite; trunk movement may be smaller due to the unstable surface or remain unchanged as the increased movement forward (trunk and hip flexion) makes it difficult to simultaneously increase the lateral movement.

4.2 Stroke frequency

Shorter race distances, with the shortest distance 200 m sprint, have been introduced during the Olympics 2012. This sprint distance has also been introduced for para-kayak athletes. When the distances decrease and become more sprint-like a clear relationship with increased paddle frequency, ranging from 89 to 141 strokes per min, has been presented in a number of studies (McDonnell et al. 2013). In this study the stroke frequency ranged from 62 strokes per min during kayaking at low intensity to 135 strokes per min at maximal intensity, indicating similar

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4.3 Subjects

In this study, all 10 participants were elite canoeists competing at national and international level. Four women participated and reflect the gender representativeness, with more males competing compared to women. No gender comparisons were made due the low number of athletes and we were not expecting to find differences between male/female. However, we know that power output is greater in men judged by faster racing time (McDonnell et al. 2013) but if this will affect the range of motion is still not known. The athletes who participated competed at various distances and the majority of the athletes competed at the short sprint distance which will be comparable to the para-canoe athletes. The next step in this study will be to compare the results from this study with the data from a group of para-athletes.

4.4 Conclusion

This study assessed joint angle motion from upper and lower extremities and the trunk in elite able-bodied kayakers. The ranges of motion for all major joints were calculated and the results from this study can serve as adequate reference values in the development of an evidence-based classification system for para-kayakers.

4.5 Limitation

A limitation in this study was that we have not been able to analyze and present the paddle force recorded during the tests and therefore we are not able to make any further conclusions if there are any asymmetries in power output between body sides observed in this group.

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5. References

Altmann V C, Groen B E, J van Limbeek, Vanlandewijck Y C & Keijsers N L W. (2013). Reliability of the revised wheelchair rugby trunk impairment classification system. Spinal Cord, vol. 51, s. 913-918.

Beckman EM & Tweedy SM. (2009). Towards evidence-based classification in Paralympic athletics: evaluating the validity of activity limitation tests for use in classification of Paralympic running events. J Sports and Medicine, vol. 43(139), s. 1067-1072 .

Baker J, Rathg D, Sanders R & Kelly B. (2011). A three-dimensional analysis of male and female elite spring kayak paddlers. Scientific proceedings of the Xv11th International Society of

Biomechanics in sports conference. S. 53-56.

Begon M, Lacouture P & Colloud, F. (2008). 3D kinematic comparison between on-water and on ergometer kayaking. Conference on biomechanics in sports. vol.14(1), s. 502-5

Bjerkefors A, Jansson A & Thorstensson A. (2006). Shoulder muscle strength in paraplegics before and after kayak ergometer training. Eur J Appl Physiol; vol. 97(5), s.613-8.

Bjerkefors A & Thorstensson A. (2006). Effects of kayak ergometer training on motor performance in paraplegics. Int J Sports Med, vol. 27(10), s. 824-9.

Bjerkefors A, Carpenter MG & Thorstensson A. (2007). Dynamic trunk stability is improved in paraplegics following kayak ergometer training. Scand J Med Scie Sport, vol. 17(6), sid. 672-9. Brown M, Lauder M & Dyson R. National analysis of sprint kayaking. (2011). Differentiating between ability levels. International Journal of Performance Analysis in Sport, vol. 11, s. 171-183.

Fleming, N, Donne, B & Fletcher, D. (2012). Effect of Kayak elastic tension on upper limb EMG activity and 3d kinematic. Department of Kinesiology, J Sports Science and Medicine, vol. 11, s. 430-437.

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Grigorenko A, Bjerkefors A, Rosdahl H, Hultling C, Alm M & Thorstensson A. (2004). Sitting balance and effects of kayak training in paraplegics. J. Rehabil Med, vol. 36(3), s. 110-6. Kendal SJ & Sanders RH. (1992). The technique of elite flatwater kayak using the wing blade. Int J Sport Biomechanics, vol. 8, s. 233-250.

McDonnel, LK, Patria A. Hume, & Vilker Nolte. (2013). A deterministic model based on evidence for the associations between kinemativ variables and sprint kayak performance. Sport

Biomechanics, vol.12, s. 205-220.

Mann RV & Kearney JT. (1980). A biomechanical analysis of the Olympic-style flatwater kayak stroke. Med Sci Sports Exerc, vol. 12(3), s. 183-188.

Michael JS, Smith RM & Rooney KB. (2009). Determinants of kayak paddling performance.

Sports Biomechanics, vol. 8(2), s. 167-179.

Michael JS, Rooney KB & Smith RM. (2012). The dynamics of elite paddling on a kayak simulator. J Sport Sci, vol. vol. 30(7), s. 661-8.

McKean MR & Burkett B. (2010). The relationship between joint range of motion, muscular strength, and race time for sub-elite flat water kayakers. J Science and Medicin in Sport, vol. 13, s. 537-542.

Nilsson JE & Rosdahl HG. (2013). New Devices for Measuring Forces on the Kayak Foot-Bar and on the Seat During Flat-Water Kayak Paddling. Int J Sports Physiol Perform, vol. 9(2), s. 365-70.

Plagenhoef S. (1979). Biomechanical analysis of Olympic flatwater kayaking and canoeing. Res

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Pernot HFM, Lannem AM, Geers RPJ, Ruijters EFG, Bloemendal M & Seelen HAM. (2011). Validity of the test-table-test for nordic skiing for classification of paralympic sit-ski sports participants. International Spinal Cord Scoiety, vol. 49, s. 935-941.

Sanders RH & Kendal SJ. (1992). A description of Olympic flatwater kayak stroke technique: J

of Science in Sport Medicine. S.25-30.

Trevithick BA, Ginn KA, Halaki M & Balnave R. (2007). Shoulder muscle recruitment patterns during kayak stroke performed on a paddling ergometer. J Electromyigr Kinesiol, vol. 17(1), s. 74-79.

Tweedy SM & Valandvejick YC. (2011). International Paralympic Committee position stand - background and scientific principles of classification in Paralympic sport. J Sports Med. vol. 45(1), s. 259-269.

Vanlandewijck, YC, Verellen J & Tweedy S. (2011). Towards evidens-based classification in wheelchair sports: Impact of seating position on weelchair acceleration. J Sports sciences, vol. 29(10), s. 1089-1096.

Wassinger CA, Myers JB, Sell TC, Oyama S, Rubenstein EN & Lephart SM. (2011).

Scapulohumeral kinematic assessment of the forward kayak stroke in experienced whitewater kayakers. Sports Biomechanics, vol. 10(2), s. 98-109.

Wassinger, CA. (2007). Biomechanical and Physical Characteristics of Whitewater Kayakers with and without Shoulder Pain. Doctoral Dissertation, vol. 8(1), s. 1-124.

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6. Appendix

Hälsodeklaration

Datum: Namn: Födelseår: Vikt: kg Längd: cm Adress: Telefonnummer:

Har Du tidigare haft eller har nu :

JA NEJ VET EJ

- Diabetes?

□

- Högt blodtryck?

□

- Lågt blodtryck eller svimningsattacker?

□

- Hjärtsjukdom?

□

- Epilepsi eller någonsin haft ett anfall / kramper?

□

- Någon sjukdom som involverar hjärnan?

□

- Någon annan neurologisk sjukdom eller skada?

□

- Astma?

□

- Lungsjukdom?

□

- Magsår, mag- eller tarmkatarr?

□

- Leversjukdomar?

□

- Muskelsjukdomar?

□

- Allergi / eksem?

□

SMÄRTOR / BESVÄR / SKADOR PERSONUPPGIFTER

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Har Du själv: JA NEJ - Ryggbesvär?

□

- Ledskador / ledsmärtor?

□

- Muskelskador / muskelsmärtor?

□

- Huvudvärk (ofta förekommande, långvarig eller migrän)?

□

- Bröstsmärta eller obehag i bröstet vid ansträngning?

□

- Kraftig ”onormal” andfåddhet vid ansträngning?

□

- Känsla av hjärtklappning eller rytmrubbning vid ansträngning?

□

- Svimning eller nära svimning vid ansträngning?

□

- Yrsel vid ansträngning?

□

LÄKEMEDEL

JA NEJ

- Har du fått vaccination nyligen?

□

- Äter du smärtstillande pga värken?

□

- Använder du sömnmedel?

□

- Har du ordinerats mediciner för långtidsbruk?

□

- Vilket läkemedel? När?

________________________________________

FYSISKA AKTIVITETER

Hur ofta tränar du per vecka?

Hur många timmar totalt tränar du per vecka?

Vilken typ av träningsform

Tränar du kombinerat för din idrottsgren?

Har du undvikit eller avbrutit träning de senaste dagarna pga. skada eller hälsoskäl?

JA NEJ

□ □

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Vilken nivå tävlar du på? Internationell Nationell Region

ÖVRIGT

JA NEJ

- Känner du dig fullt frisk?

□

- Är du gravid?

□

- Röker du?

□

- Snusar du?

□

Övrig:

Förutsättningar för deltagande i undersökningen samt hälsodeklaration

Jag har muntligen informerats om studien och dessutom tagit del av dem skriftliga informationen om försökets genomförande. Jag är medveten om att mitt deltagande är fullt frivilligt och att jag när som helst och utan närmare förklaring kan avbryta mitt deltagande. Jag uppfattar mih om fullt frisk och ser inga medicinska hinder för deltagande i undersökningen.

Stockholm den /

__________________________ ________________________ Försökspersonens namnteckning Försöksledarens namnteckning

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Information till dig som är intresserad att

delta i studien:

Tredimensionell rörelseanalys under paddling på kajakergometer – en första del i evidensbaserad klassificering av parakanotister till Paralympics 2016

Målsättning

I december 2010 adderade IPC kanotpaddling som ny gren till Paralympics 2016. The International Canoe Federation (ICF) har därför initierat ett projekt som syftar till utvärdera, utveckla och presentera ett förslag till IPC gällande ett validerat och modifierat klassificeringssystem för parakanotiser. Den första delen avser att definiera rörelseomfånget (vinkelrörelsen i skuldra, armbåge, hand, bål, bäcken, höft, knä och ankelled) under kajakpaddling. Syftet med studien är att i samarbete med ICF, utvärdera och utveckla ett förslag gällande klassificeringen av parakanotister till kommande Paralympics 2016. Förslaget ska innehålla ett evidensbaserat instrument för bedömning av rörelseomfånget för parakanotister. Bedömningsinstrumentet ska utgå från det maximala rörelseutslaget som krävs under paddling hos icke-skadade elitkanotister. Resultaten från studierna ska ligga till grund för en tydlig definition mellan klasserna för parakanotister

Efter testernas gång kommer vi att analysera och redogöra resultaten med hjälp av våra frågeställningar:

- Vilket är det totala rörelseomfånget för skuldra, armbåge, handled, bål, höft, knä samt fotled under paddling och påverkas det totala rörelseomfånget vid ändrad kraftutveckling dvs. vid lång, medel- och högintensiv paddling?

- Finns det några sidoskillnader mellan höger och vänster sida som kan påverka den totala effektutvecklingen?

Testerna kommer att genomföras på Gymnastik- och idrottshögskolan i Stockholm.

Vi vänder oss till dig som är:

Man eller kvinna, tävlar på elit nivå. Vi ser gärna att du är specialiserad på sprint, distansen 200m. Du ska förövrigt vara fullt frisk dvs inte ha någon diagnostiserad hjärt- och lungsjukdom, eller annan åkomma som kan vara av betydelser för forskningsresultaten.

Risker för komplikationer

Samtliga metoder som vi använder är väl beprövade och risken för komplikationer bedömer vi som mycket små. Du kan när som helst kontakta försöksledarna efter testet.

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Ekonomisk ersättning

Ett försökspersonsarvode på 600:- utbetalas efter avslutat test.

Vid frågor angående testtillfälle eller uppsatsen vänligen ta kontakt med studerande eller handledare

.

Stockholm den 3 mars 2013

Mastersstudent Handledare Pascal Zakaria Anna Bjerkefors

Mail: pascal.zakaria@gmail.com Huvudansvarig forskare

Tfn: 0704XXXXXX Gymnastik och Idrottshögskolan Box 5626

114 86 Stockholm

_____________________________________________________________________________

Till dig som vill medverka i studien!

Observera att det är viktigt för dig att veta att du när som helst har möjlighet att avbryta din medverkan i vår undersökning utan att du behöver motivera varför. Dina data från undersökningen kommer att hanteras konfidentiellt. Alla deltagare erhåller en kod som används för protokoll och mätresultat. Ansvariga för

undersökningen kommer att kunna härleda koden till enskilda deltagare. I den slutliga sammanställningen kan ingen individuell person identifieras av utomstående personer.

Jag har muntligen informerats om studien och jag har tagit del av ovanstående skriftliga information. Jag är medveten om att mitt deltagande är helt frivilligt och att jag när som helst utan närmare förklaring kan avbryta mitt deltagande. Namn:………. Adress:……… Telefonnummer:……….. E-post:……….. ________________________________________ Datum ________________________________________ Namnteckning

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Tredimensionell rörelseanalys under paddling på kajakergometer

Markörer (totalt = 72, 150 Hz, 12 Pro reflex kameror

(Huvud = 2, Arm vänster och högersegment 16 totalt, bål = 8, Ben- och fotsegment höger och vänster totalt 18, Paddel totalt 9, Kajakergometer totalt 3)

Head Head_Left Head_Right Trunk C7 T5 Th12 Sternum L_Acromion R_Acromion L_IliacChrest (ref) R_IliacChrest (ref) Arm Left L_Upperarm L_Elbow (L_ElbowMedial) L_Forearm L_Wrist L_Ulnaris L_HandRad L_HandUln Arm Right R_Upperarm R_Elbow (R_Elbowmedial) R_Forearm R_Wrist R_Ulnaris R_HandRad R_HandUln Leg Right R_Thigh1 R_Thigh2 R_Thigh3 R_Knee Tibia R_FootAnkle

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R_FootSub R_FootHeel R_FootToe Leg Left L_Thigh1 L_Thigh2 L_Thigh3 L_Knee Tibia L_FootAnkle L_FootSub L_FootHeel L_FootToe Paddle PaddleLeft PaddleMidle PaddleRight

Power and Rope Right

Powerright1 Powerright2 Roperight

Power and Rope Left

Powerleft1 Powerleft2 Ropeleft

Ergo(meter) Right and Left

ErgoRight ErgoLeft ErgoBack