Effect of Fatiguing Wheelchair Propulsion and Weight Relief Lifts on Subacromial Space in Wheelchair Users

Frontiers in Rehabilitation Sciences, 2022 · DOI: 10.3389/fresc.2022.849629 · Published: April 27, 2022

Spinal Cord Injury Assistive Technology Orthopedics

Simple Explanation

This study investigates the impact of wheelchair use and weight relief lifts on the shoulder space (subacromial space) in wheelchair users with spinal cord injuries. It examines how these activities affect the space in the shoulder and whether fatigue from wheelchair use makes a difference. The study also looks at whether a person's fitness level and other characteristics, like injury level and weight, play a role in shoulder space and potential pain.

Study Duration

Not specified

Participants

50 manual wheelchair users with SCI

Evidence Level

Not specified

Key Findings

1
Weight relief lifts significantly reduce the space in the shoulder (AHD) compared to resting positions.
2
Higher anaerobic work capacity (fitness) helps stabilize the shoulder during weight relief lifts, maintaining more space.
3
Fatigue from wheelchair use does not have a direct effect on shoulder space size.

Research Summary

The study aimed to identify intervention targets for reducing shoulder pain in wheelchair users with SCI by examining changes in subacromial space (AHD and OccRatio) with fatiguing wheelchair propulsion and different loading conditions (unloaded position vs. WRL). A significant reduction in AHD was found during WRL compared to the unloaded position, with no effect of fatiguing wheelchair propulsion on the subacromial space. A higher anaerobic work capacity was beneficial in stabilizing the shoulder during WRL. Subject characteristics associated with a larger subacromial space were lower lesion level, shorter time since injury, impaired ROM in external rotation, a lower BMI and a higher anaerobic work capacity. These findings may assist clinicians in designing a shoulder injury prevention program.

Practical Implications

Shoulder Injury Prevention Programs

The study's findings can help clinicians design targeted injury prevention programs for wheelchair users.

Alternative Pressure Relief Methods

Encouraging alternative pressure relief techniques, like forward or side leans, instead of weight relief lifts, may reduce shoulder strain.

Fitness Training

Preventive fitness training to increase wheelchair user capacity and improve shoulder stability during weight-bearing activities is crucial.

Study Limitations

1
The fatiguing wheelchair propulsion protocol may not fully represent the demands of everyday activities.
2
Ultrasound measures provide only two-dimensional assessments of subacromial space.
3
The study excluded participants with upper-extremity pain that limits wheelchair propulsion.

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