Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics during Wheelchair Mobility

J Biomech, 2014 · DOI: 10.1016/j.jbiomech.2013.11.014 · Published: January 3, 2014

Assistive Technology Pediatrics Biomechanics

Simple Explanation

This research introduces a model designed to assess how the joints in the upper body of children who use manual wheelchairs move and handle forces during wheelchair use. The goal is to better understand and prevent potential injuries. The model tracks the movement and forces in the thorax, clavicle, scapula, upper arm, forearm, and hand, considering the various joints in the upper extremity. By understanding these joint dynamics, clinicians and engineers can improve wheelchair design, training programs, and rehabilitation strategies, ultimately aiming to reduce pain and prevent injuries in young wheelchair users.

Study Duration

Not specified

Participants

Single 17 year-old male with a C7 spinal cord injury (SCI)

Evidence Level

Level 4, Case Study

Key Findings

1
The subject exhibited wrist extension angles up to 60°, indicating a high degree of wrist strain during wheelchair propulsion.
2
Large elbow ranges of motion were observed, particularly in the sagittal and transverse planes, suggesting significant elbow joint involvement in the propulsion process.
3
Peak glenohumeral joint forces reached up to 10% of the subject's body weight, highlighting substantial stress on the shoulder joint.

Research Summary

This study introduces a custom biomechanical model to quantify upper extremity joint dynamics in pediatric manual wheelchair users (MWU). The model was used to evaluate a 17-year-old male with SCI, revealing significant wrist extension, elbow motion, and glenohumeral joint forces during wheelchair propulsion. The model identified statistically significant asymmetry in joint dynamics between the dominant and non-dominant sides, which has implications for understanding and preventing upper extremity pathologies.

Practical Implications

Improved Wheelchair Prescription

The model can inform the selection and customization of wheelchairs to better suit the biomechanical needs of pediatric users, potentially reducing joint stress.

Targeted Training Programs

Understanding joint dynamics can guide the development of training programs that promote efficient and less stressful propulsion techniques.

Enhanced Rehabilitation Strategies

The model can be used to monitor rehabilitation progress and tailor interventions to address specific joint loading and movement patterns.

Study Limitations

1
Single case study limits generalizability.
2
The model's accuracy depends on the precision of marker placement and anthropometric data.
3
Further research is needed to correlate model outputs with clinical outcomes, such as pain and pathology.

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