The effect of level of spinal cord injury on shoulder joint kinetics during manual wheelchair propulsion

Objective. The effects of spinal cord injury level on shoulder kinetics during manual wheelchair propulsion were studied. Design. Single session data collection in a laboratory environment. Methods. Male subjects were divided into four groups: low level paraplegia ( n=17), high level paraplegia ( n=...

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Bibliographic Details
Published in:Clinical biomechanics (Bristol) 2001-11, Vol.16 (9), p.744-751
Main Authors: Kulig, Kornelia, Newsam, Craig J, Mulroy, Sara J, Rao, Sreesha, Gronley, JoAnne K, Bontrager, Ernest L, Perry, Jacquelin
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
Arm - physiology
Biomechanical Phenomena
Ergometry
Humans
Kinetics
Male
Paraplegia - physiopathology
Physical Exertion - physiology
Quadriplegia - physiopathology
Shoulder
Shoulder Joint - physiology
Spinal cord injury
Torque
Wheelchair propulsion
Wheelchairs
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Summary:Objective. The effects of spinal cord injury level on shoulder kinetics during manual wheelchair propulsion were studied. Design. Single session data collection in a laboratory environment. Methods. Male subjects were divided into four groups: low level paraplegia ( n=17), high level paraplegia ( n=19), C7 tetraplegia (C7, n=16) and C6 tetraplegia (C6, n=17). Measurements were recorded using a six-camera VICON motion analysis system, a strain gauge instrumented wheel, and wheelchair ergometer. Shoulder joint forces and moments were calculated using the inverse dynamics approach. Results. Mean self-selected propulsion velocity was higher in the paraplegic (low paraplegia=90.7 m/min; high paraplegia=83.4 m/min) than tetraplegic (C7=66.5 m/min; C6=47.0 m/min) groups. After covarying for velocity, no significant differences in shoulder joint moments were identified. However, superior push force in subjects with tetraplegia (C7=21.4 N; C6=9.3 N) was significantly higher than in those with high paraplegia (7.3 N), after covarying velocity. Conclusions. The superior push force in the tetraplegic groups coupled with weakness of thoraco-humeral depressors increases susceptibility of the subacromial structures to compression. Relevance Increased vertical force at the shoulder joint, coupled with reduced shoulder depressor strength, may contribute to shoulder problems in subjects with tetraplegia. Wheelchair design modifications, combined with strength and endurance retention, should be considered to prevent shoulder pain development.
ISSN:0268-0033
1879-1271
DOI:10.1016/S0268-0033(01)00066-3