Shoulder demands in manual wheelchair users across a spectrum of activities |
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| Authors: | Melissa MB Morrow Wendy J Hurd Kenton R Kaufman Kai-Nan An |
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| Institution: | 1. Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA;2. Department of Biological Sciences, University of Southern California, USA;3. Department of Aerospace & Mechanical Engineering, University of Southern California, USA;4. Rehabilitation Engineering Program, Rancho Los Amigos National Rehabilitation Center, Downey, Los Angeles, CA, USA;1. Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH;2. Case Western Reserve University, Cleveland, OH;1. Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada;2. GF Strong Rehabilitation Research Lab, Vancouver, BC, Canada;3. Vancouver Coastal Health Research Institute, Vancouver, BC, Canada;4. Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada;5. International Collaboration on Repair Discoveries, Vancouver, BC, Canada;1. Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada;2. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;3. The Miami Project to Cure Paralysis, Department of Neurological Surgery, University of Miami, Miami, FL;4. Rehabilitation Institute of Chicago, Chicago, IL;5. School of Medicine, Northwestern University, Chicago, IL;6. Kessler Foundation, West Orange, NJ;7. Kessler Institute for Rehabilitation, West Orange, NJ;8. Capital District Health Authority, Halifax, NS;9. School of Rehabilitation, Occupational Therapy Program, Faculty of Medicine, University of Montreal, Montreal, QC, Canada;1. Department of Veterans Affairs, Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States;2. Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States;3. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States;4. College of Computer and Information Science, Northeastern University, Boston, MA, United States;5. Department of Health Sciences, Northeastern University, Boston, MA, United States;6. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States;1. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Mayo Clinic, Rochester, MN 55905, USA;2. Division of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic, Rochester, MN 55905, USA;3. Program in Physical Therapy, Mayo Clinic School of Health Sciences Mayo Clinic, Rochester, MN 55905, USA;4. Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Department of Physical Medicine and Rehabilitation Mayo Clinic, Rochester, MN 55905, USA;5. Division of Biomedical Informatics and Statistics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA |
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| Abstract: | ObjectiveInvestigate shoulder joint kinetics over a range of daily activity and mobility tasks associated with manual wheelchair propulsion to characterize demands placed on the shoulder during the daily activity of manual wheelchair users.DesignCase series.SubjectsTwelve individuals who were experienced manual wheelchair users.MethodsUpper extremity kinematics and handrim wheelchair kinetics were measured over level propulsion, ramp propulsion, start and stop over level terrain, and a weight relief maneuver. Shoulder intersegmental forces and moments were calculated from inverse dynamics for all conditions.ResultsWeight relief resulted in significantly higher forces and ramp propulsion resulted in significantly higher moments than the other conditions. Surprisingly, the start condition resulted in large intersegmental moments about the shoulder equivalent with that of the ramp propulsion, while the demand imparted by the stop condition was shown to be equivalent to level propulsion across all forces and moments.ConclusionsThis study provides characterization of daily living and mobility activities associated with manual wheelchair propulsion not previously reported and identifies activities that result in higher shoulder kinetics when compared to standard level propulsion. |
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