Characterization of the shoulder net joint moment during manual wheelchair propulsion using four functional axes |
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| Affiliation: | 1. University of Southern California, United States;2. Rancho Los Amigos National Rehabilitation Center, United States;1. School of Electrical & Electronic Engineering, University College Dublin, Dublin, Ireland;2. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland;3. Biomedical Sciences Department, Neuromuscular Physiology Laboratory, University of Padova, Italy;1. Institute of Movement and Neuroscience, German Sports University, Cologne, Germany;2. Faculty of Medical Engineering and Technomathematics, FH Aachen University of Applied Sciences, Aachen, Germany;1. McMaster University, Department of Medicine, Division of Physical Medicine and Rehabilitation, Hamilton, Ontario, Canada;2. University of Waterloo, Faculty of Applied Health Sciences, Department of Kinesiology, Digital Industrial Ergonomics and Shoulder Evaluation Laboratory (DIESEL), Waterloo, Ontario, Canada;3. University of Saskatchewan, College of Medicine, Department of Community Health and Epidemiology, Saskatoon, Saskatchewan, Canada;4. University of Saskatchewan, College of Medicine, School of Rehabilitation Science, Saskatoon, Saskatchewan, Canada;1. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States;2. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States;3. Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, United States;1. Department of Physical Therapy, Universidade Federal de São Carlos, Rodovia Washington Luis km 235, São Carlos, SP 13565-905, Brazil;2. Department of Clinical Research, Indian Spinal Injuries Center, Vasant Kunj, New Delhi 110070, India |
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| Abstract: | Understanding how individuals distribute mechanical demand imposed on their upper extremity during physically demanding activities provides meaningful insights to preserve function and mitigate detrimental mechanical loading of the shoulder. In this study, we hypothesized that parameterization of the shoulder net joint moment using four functional axes could characterize distribution tendencies about the shoulder during manual wheelchair propulsion and that regardless of demographics, a shoulder flexor dominant NJM distribution would be predominantly used by individuals with paraplegia (n = 130). Forces and kinematics of the upper extremity and trunk were quantified using motion capture and an instrumented wheel during steady state manual wheelchair propulsion at self-selected fast speeds on a stationary ergometer. The results indicate that parsing out the internal/external rotation component of the shoulder net joint moment about the upper arm and distributing the remainder across the three orthogonal axes of the torso was successful in identifying common shoulder net joint moment distribution techniques used across individuals with paraplegia during manual wheelchair propulsion. Distribution tendencies were predominantly flexor dominant across injury level, gender, time since injury, body mass index, and height demographics. The 4-axis parameterization of the shoulder NJM effectively differentiated moment distribution tendencies used by individuals during manual wheelchair propulsion using a functionally relevant representation of shoulder kinetics. Use of the four-axis parameterization of joint kinetics in future studies is expected to provide important insights that can advance knowledge, preserve function, and inform clinical decisions. |
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| Keywords: | Joint kinetics Coordinate system Moments Net joint moment Shoulder Wheelchair propulsion |
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