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Shoulder joint kinetics and pathology in manual wheelchair users

Mercer, JL and Boninger, M and Koontz, A and Ren, D and Dyson-Hudson, T and Cooper, R (2006) Shoulder joint kinetics and pathology in manual wheelchair users. Clinical Biomechanics, 21 (8). 781 - 789. ISSN 0268-0033

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Background: Manual wheelchair users rely heavily on their upper limbs for independent mobility which likely leads to a high prevalence of shoulder pain and injury. The goal of this study was to examine the relationship between shoulder forces and moments experienced during wheelchair propulsion and shoulder pathology. Methods: Kinetic and kinematic data was recorded from 33 subjects with paraplegia as they propelled their wheelchairs at two speeds (0.9 and 1.8 m/s). Shoulder joint forces and moments were calculated using inverse dynamic methods and shoulder pathology was evaluated using a physical exam and magnetic resonance imaging scan. Findings: Subjects who experienced higher posterior force (Odds Ratio (OR) = 1.29, P = 0.03), lateral force (OR = 1.35, P = 0.047), or extension moment (OR = 1.35, P = 0.09) during propulsion were more likely to exhibit coracoacromial ligament edema. Individuals who displayed larger lateral forces (OR = 4.35, P = 0.045) or abduction moments (OR = 1.58, P = 0.06) were more likely to have coracoacromial ligament thickening. Higher superior forces (OR = 1.05, P = 0.09) and internal rotation moments (OR = 1.61 P = 0.02) at the shoulder were associated with increased signs of shoulder pathology during the physical exam. Interpretation: Specific joint forces and moments were related to measures of shoulder pathology. This may indicate a need to reduce the overall force required to propel a wheelchair in order to preserve upper limb integrity. Potential interventions include changes to wheelchair setup, propulsion training, or alternative means of mobility. © 2006 Elsevier Ltd. All rights reserved.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Mercer, JL
Boninger, Mboninger@pitt.eduBONINGER
Koontz, Aakoontz@pitt.eduAKOONTZ
Ren, Ddir8@pitt.eduDIR8
Dyson-Hudson, T
Cooper, RRCOOPER@pitt.eduRCOOPER
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 October 2006
Date Type: Publication
Journal or Publication Title: Clinical Biomechanics
Volume: 21
Number: 8
Page Range: 781 - 789
DOI or Unique Handle: 10.1016/j.clinbiomech.2006.04.010
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0268-0033
MeSH Headings: Adult; Aged; Anthropometry--methods; Biomechanics; Female; Humans; Kinetics; Male; Middle Aged; Muscle, Skeletal--pathology; Muscle, Skeletal--physiology; Shoulder--physiopathology; Shoulder Joint--pathology; Shoulder Joint--physiology; Spinal Cord Injuries; Torque; Wheelchairs
PubMed ID: 16808992
Date Deposited: 15 Oct 2012 14:15
Last Modified: 02 Feb 2019 16:56


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