Handrim Wheelchair Propulsion Technique in Individuals With Spinal Cord Injury With and Without Shoulder Pain
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Published:2023-03-14
Issue:10
Volume:102
Page:886-895
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ISSN:1537-7385
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Container-title:American Journal of Physical Medicine & Rehabilitation
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language:en
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Short-container-title:Am J Phys Med Rehabil
Author:
Braaksma Jelmer,Vegter Riemer J.K.,Leving Marika T.,van der Scheer Jan W.,Tepper Marga,Woldring Ferry A.B.,van der Woude Lucas H.V.,Houdijk Han,de Groot Sonja
Abstract
Objective
The aim of this study was to compare handrim wheelchair propulsion technique between individuals with spinal cord injury with and without shoulder pain.
Design
A cross-sectional study including 38 experienced handrim wheelchair users with spinal cord injury was conducted. Participants were divided into the “shoulder pain” (n = 15) and “no-shoulder pain” (n = 23) groups using the Local Musculoskeletal Discomfort scale. Kinetic and spatiotemporal aspects of handrim wheelchair propulsion during submaximal exercise on a motor-driven treadmill were analyzed. Data were collected using a measurement wheel instrumented with three-dimensional force sensors.
Results
After correction for confounders (time since injury and body height), linear regression analyses showed that the pain group had a 0.30-sec (95% confidence interval, −0.5 to −0.1) shorter cycle time, 0.22-sec (95% confidence interval, −0.4 to −0.1) shorter recovery time, 15.6 degrees (95% confidence interval, −27.4 to −3.8) smaller contact angle, and 8% (95% confidence interval, −15 to 0) lower variability in work per push compared with the no-pain group. Other parameters did not differ between groups.
Conclusions
This study indicates that individuals with spinal cord injury who experience shoulder pain propel their handrim wheelchair kinematically differently from individuals with spinal cord injury without shoulder pain. This difference in propulsion technique might be a pain-avoiding mechanism aimed at decreasing shoulder range of motion.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation
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