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Wheelchair pushrim kinetics: Body weight and median nerve function

Boninger, ML and Cooper, RA and Baldwin, MA and Shimada, SD and Koontz, A (1999) Wheelchair pushrim kinetics: Body weight and median nerve function. Archives of Physical Medicine and Rehabilitation, 80 (8). 910 - 915. ISSN 0003-9993

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Objectives: Individuals who use manual wheelchairs are at high risk for median nerve injury and subsequent carpal tunnel syndrome (CTS). To gain a better understanding of the mechanism behind CTS in manual wheelchair users, this study examined the relation between (1) pushrim biomechanics and function of the median nerve, (2) pushrim biomechanics and subject characteristics, and (3) median nerve function and subject characteristics. Design: Case series. Setting: Biomechanics laboratory and an electromyography laboratory. Participants: Thirty-four randomly recruited individuals with paraplegia who use a manual wheelchair for mobility. Intervention: Subjects propelled their own wheelchair on a dynamometer at 0.9m/sec and 1.8m/sec. Bilateral biomechanical data were obtained using a force- and moment-sensing pushrim and a motion analysis system. Bilateral nerve conduction studies focusing on the median nerve were also completed. Main Outcome Measures: Pearson's correlation coefficients between subject characteristics, median nerve conduction studies, and propulsion biomechanics; a regression model of nerve conduction studies incorporating subject characteristics and pushrim biomechanics. Results: Subject weight was significantly related to median nerve latency (r = .36, p = .03) and median sensory amplitude (r = -.43, p = .01). Height was also significantly related to median sensory amplitude (r = -.58, p = .01). Subject weight was significantly related to the peak resultant force applied to the pushrim (r = .59, p < .001). Height, weight, and weight-normalized pushrim forces were successfully incorporated into a linear regression model predicting median sensory amplitude (r = .63, p < .05) and mean median latency (r = .54, p < .05). Conclusion: This study found subject weight to be related to pushrim forces and median nerve function. Independent of subject weight, pushrim biomechanics were also related to median nerve function. Through weight loss and changes in pushrim biomechanics, it may be possible to prevent median nerve injury in manual wheelchair users.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Boninger, MLboninger@pitt.eduBONINGER
Baldwin, MA
Shimada, SD
Koontz, Aakoontz@pitt.eduAKOONTZ
Centers: Other Centers, Institutes, Offices, or Units > Human Engineering Research Laboratories
Date: 1 January 1999
Date Type: Publication
Journal or Publication Title: Archives of Physical Medicine and Rehabilitation
Volume: 80
Number: 8
Page Range: 910 - 915
DOI or Unique Handle: 10.1016/s0003-9993(99)90082-5
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Refereed: Yes
ISSN: 0003-9993
MeSH Headings: Adult; Body Weight; Carpal Tunnel Syndrome--etiology; Carpal Tunnel Syndrome--physiopathology; Humans; Kinetics; Linear Models; Median Nerve--injuries; Median Nerve--physiology; Neural Conduction; Spinal Cord Injuries--complications; Spinal Cord Injuries--physiopathology; Spinal Cord Injuries--rehabilitation; Time Factors; Wheelchairs--statistics & numerical data
PubMed ID: 10453767
Date Deposited: 16 Nov 2012 21:27
Last Modified: 02 Feb 2019 16:56


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