Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 4 , Pages 667-676 , April 2008

Shoulder Biomechanics During the Push Phase of Wheelchair Propulsion: A Multisite Study of Persons With Paraplegia

  • Jennifer L. Collinger, BS

      Affiliations

    • Human Engineering Research Laboratories, VA Rehabilitation Research and Development Center, VA Pittsburgh Healthcare Systems, Pittsburgh, PA
    • Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
    • Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Michael L. Boninger, MD

      Affiliations

    • Human Engineering Research Laboratories, VA Rehabilitation Research and Development Center, VA Pittsburgh Healthcare Systems, Pittsburgh, PA
    • Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
    • Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
    • Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
    • Corresponding Author InformationReprint requests to Michael L. Boninger, MD, Human Engineering Research Laboratories, VA Pittsburgh Health Care System, 7180 Highland Dr, 151R1-H, Pittsburgh, PA 15206
    • ,
  • Alicia M. Koontz, PhD, RET

      Affiliations

    • Human Engineering Research Laboratories, VA Rehabilitation Research and Development Center, VA Pittsburgh Healthcare Systems, Pittsburgh, PA
    • Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
    • Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Robert Price, MSME

      Affiliations

    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA
    • ,
  • Sue Ann Sisto, PT, MA, PhD

      Affiliations

    • Kessler Medical Rehabilitation Research and Education Corp, Spinal Cord Injury Rehabilitation Research, West Orange, NJ
    • Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ.
    • ,
  • Michelle L. Tolerico, MS

      Affiliations

    • Human Engineering Research Laboratories, VA Rehabilitation Research and Development Center, VA Pittsburgh Healthcare Systems, Pittsburgh, PA
    • Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
    • ,
  • Rory A. Cooper, PhD

      Affiliations

    • Human Engineering Research Laboratories, VA Rehabilitation Research and Development Center, VA Pittsburgh Healthcare Systems, Pittsburgh, PA
    • Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
    • Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA

References 

  1. Cooper R, Boninger M, Shimada S, Lawrence B. Glenohumeral joint kinematics and kinetics for three coordinate system representations during wheelchair propulsion. Am J Phys Med Rehabil. 1999;78:435–446
  2. Finley M, Rasch E, Keyser R, Rodgers M. The biomechanics of wheelchair propulsion in individuals with and without upper-limb impairment. J Rehabil Res Dev. 2004;41:395–402
  3. Kulig K, Rao S, Mulroy S, et al. Shoulder joint kinetics during the push phase of wheelchair propulsion. Clin Orthop Relat Res. 1998;(354):132–143Sep
  4. Mulroy S, Newsam CJ, Gutierrez D, et al. Effect of fore-aft seat position on shoulder demands during wheelchair propulsion: part 1 (A kinetic analysis). J Spinal Cord Med. 2005;28:214–221
  5. Rodgers M, Gayle GW, Figoni S, Kobayashi M, Lieh J, Glaser R. Biomechanics of wheelchair propulsion during fatigue. Arch Phys Med Rehabil. 1994;75:85–93
  6. Ballinger D, Rintala D, Hart K. The relation of shoulder pain and range-of-motion problems to functional limitations, disability, and perceived health of men with spinal cord injury: a multifaceted longitudinal study. Arch Phys Med Rehabil. 2000;81:1575–1581
  7. Pentland WE, Twomey LT. The weight-bearing upper extremity in women with long term paraplegia. Paraplegia. 1991;29:521–530
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  9. Nichols PJ, Norman PA, Ennis JR. Wheelchair user’s shoulder? (Shoulder pain in patients with spinal cord lesions). Scand J Rehabil Med. 1979;11:29–32
  10. Subbarao J, Klopfstein J, Turpin R. Prevalence and impact of wrist and shoulder pain in patients with spinal cord injury. J Spinal Cord Med. 1995;18:9–13
  11. Mercer JL, Boninger M, Koontz A, Ren D, Dyson-Hudson T, Cooper R. Shoulder joint kinetics and pathology in manual wheelchair users. Clin Biomech (Bristol, Avon). 2006;21:781–789
  12. Boninger ML, Cooper RA, Shimada SD, Rudy TE. Shoulder and elbow motion during two speeds of wheelchair propulsion: a description using a local coordinate system. Spinal Cord. 1998;36:418–426
  13. Koontz AM, Cooper RA, Boninger ML, Souza AL, Fay BT. Shoulder kinematics and kinetics during two speeds of wheelchair propulsion. J Rehabil Res Dev. 2002;39:635–650
  14. Rao S, Bontrager EL, Gronley J, Newsam CJ, Perry J. Three-dimensional kinematics of wheelchair propulsion. IEEE Trans Rehabil Eng. 1996;4:152–160
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  16. DiGiovine CP, Cooper RA, Boninger ML. Dynamic calibration of a wheelchair dynamometer. J Rehabil Res Dev. 2001;38:41–55
  17. Cooper R, Robertson R, VanSickle D, Boninger M, Shimada S. Methods for determining three-dimensional wheelchair pushrim forces and moments: a technical note. J Rehabil Res Dev. 1997;34:162–170
  18. Koontz A, Yang Y, Price R, et al. Multi-site comparison of wheelchair propulsion kinetics in persons with paraplegia. J Rehabil Res Dev. 2007;44:449–458
  19. Hanavan E. A mathematical model of the human body (Wright-Patterson Air Force Base: Aerospace Medical Research Laboratories). 1964;Oct. Report no. AMRL-TR-64-102
  20. Boninger ML, Souza AL, Cooper RA, Fitzgerald SG, Koontz AM, Fay BT. Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion. Arch Phys Med Rehabil. 2002;83:718–723
  21. McMaster W, Long S, Caiozzo V. Isokinetic torque imbalances in the rotator cuff of the elite water polo player. Am J Sports Med. 1991;19:72–75
  22. Bednarczyk JH, Sanderson DJ. Kinematics of wheelchair propulsion in adults and children with spinal cord injury. Arch Phys Med Rehabil. 1994;75:1327–1334
  23. Neer C. Impingement lesions. Clin Orthop Relat Res. 1983;(173):70–77Mar
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  25. Boninger M, Baldwin MA, Cooper R, Koontz A, Chan L. Manual wheelchair pushrim biomechanics and axle position. Arch Phys Med Rehabil. 2000;81:608–613
  26. Gutierrez D, Mulroy S, Newsam CJ, Gronley JK, Perry J. Effect of fore-aft seat position on shoulder demands during wheelchair propulsion: part 2 (An electromyographic analysis). J Spinal Cord Med. 2005;28:222–229
  27. Paralyzed Veterans of America Consortium for Spinal Cord Medicine. Preservation of upper limb function following spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med. 2005;28:434–470
  28. Boninger M, Koontz A, Sisto S, et al. Pushrim biomechanics and injury prevention in spinal cord injury: recommendations based on CULP-SCI investigations. J Rehabil Res Dev. 2005;42(3 Suppl 1):9–20
  29. Newsam CJ, Mulroy S, Gronley J, Bontrager EL, Perry J. Temporal-spatial characteristics of wheelchair propulsion: effects of level of spinal cord injury, terrain, and propulsion rate. Am J Phys Med Rehabil. 1996;75:292–299
  30. NIOSH. Shoulder musculoskeletal disorders: evidence for work-relatedness (Musculoskeletal disorders and workplace factors: a critical review of epidemiology for work related musculoskeletal disorders of the neck, upper extremity, and low back). In: Cincinnati: National Institute for Occupational Safety and Health, Publications Dissemination; 1997;p. 122–194
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 Supported by the National Institute on Disability and Rehabilitation Research (grant no. H133A011107), Veterans Affairs Rehabilitation Research and Development Service, U.S. Department of VA Affairs (grant no. B3057R), University of Pittsburgh Model Center on Spinal Cord Injury (grant no. H133N000019), and a National Science Foundation Graduate Research Fellowship.

 A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit upon the author or 1 or more of the authors. Boninger and Cooper have a nonfinancial affiliation with Three Rivers Holdings in the form of subcontracted grants. In addition, Three Rivers Holdings licenses patents unrelated to this publication from the University of Pittsburgh. Boninger and Cooper receive royalties through the University of Pittsburgh from the sales of these licensed inventions.

PII: S0003-9993(08)00031-2

doi: 10.1016/j.apmr.2007.09.052

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 4 , Pages 667-676 , April 2008

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