Changes to Biceps and Supraspinatus Tendons in Response to a Progressive Maximal Treadmill-Based Propulsion Aerobic Fitness Test in Manual Wheelchair Users: A Quantitative Musculoskeletal Ultrasound Study

Abstract

Relevance. To develop personalized cardiorespiratory fitness training programs among manual wheelchair users and assess their impact over time, the completion of a performance-based maximal cardiorespiratory fitness test is required. However, these tests could potentially increase the risk exposure for the development of upper limb secondary musculoskeletal impairments. Hence, finding an equilibrium between the need to measure aerobic fitness and the increased risk of developing secondary musculoskeletal impairments when completing performance-based test is fundamental. Objective. To investigate if the completion of a recently developed treadmill-based wheelchair propulsion maximal progressive workload incremental test alters the integrity of the long head of the biceps and supraspinatus tendons using musculoskeletal ultrasound imaging biomarkers. Method. Fifteen manual wheelchair users completed the incremental test. Ultrasound images of the long head of the biceps and supraspinatus tendons were recorded before, immediately after, and 48 hours after the completion of the test using a standardized protocol. Geometric, composition, and texture-related ultrasound biomarkers characterized tendon integrity. Results. Participants propelled during $10.2\pm 2.9\text{minutes}$ with the majority ( $N=13/15$ ) having reached at least the eighth stage of the $\text{test}(\text{speed}=0.8\text{m}/\text{s}$ ; $\text{slope}={3.6}^{°}$ ). All ultrasound biomarkers characterizing tendon integrity, measured in the longitudinal and transversal planes for both tendons, were similar ( $p=0.063$ to 1.000) across measurement times. Conclusion. The performance of the motorized treadmill wheelchair propulsion test to assess aerobic fitness produced no changes to ultrasound biomarkers of the biceps or supraspinatus tendons. Hence, there was no ultrasound imaging evidence of a maladaptive response due to overstimulation in these tendons immediately after and 48 hours after the performance of the test.