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  4. Humeral elevation workspace during daily life of adults with spinal cord injury who use a manual wheelchair compared to age and sex matched able-bodied controls

Humeral elevation workspace during daily life of adults with spinal cord injury who use a manual wheelchair compared to age and sex matched able-bodied controls

PLOS ONE, 2021 · DOI: https://doi.org/10.1371/journal.pone.0248978 · Published: April 23, 2021

Spinal Cord InjuryOrthopedicsBiomechanics

Simple Explanation

This study investigates the arm movements of manual wheelchair users with spinal cord injuries (SCI) compared to able-bodied individuals. It focuses on how much time each group spends with their upper arm at different elevation angles during daily activities. Researchers used inertial measurement units (IMUs) to track arm positions throughout the day. The goal was to see if wheelchair users spend more time in arm positions that might compress shoulder tendons, potentially contributing to shoulder pain. The study found that individuals with SCI spent a larger portion of their day with their arms elevated in a range associated with tendon compression compared to the control group.

Study Duration
One to two days
Participants
34 individuals with SCI and 34 age- and sex-matched controls
Evidence Level
Not specified

Key Findings

  • 1
    Individuals with SCI spent a significantly lower percentage of the day in 0–30˚ of humeral elevation compared to controls.
  • 2
    The SCI cohort spent a significantly higher percentage of time in elevations associated with tendon compression (30–60˚ of humeral elevation) than controls.
  • 3
    There was no evidence of the effect of injury level, years of MWC use, age, or sex on the humeral elevation workspace for individuals with SCI.

Research Summary

The study compared the humeral elevation workspace of individuals with SCI who use manual wheelchairs (MWC) to age- and sex-matched able-bodied controls. Individuals with SCI spent significantly more time in humeral elevations associated with supraspinatus tendon compression (30–60˚) than controls. The findings suggest that increased time in this elevation range may contribute to the higher prevalence of shoulder pain and pathology in MWC users with SCI.

Practical Implications

Targeted Interventions

Develop interventions to reduce time spent in the 30-60 degree humeral elevation range for MWC users.

Wheelchair Adjustments

Optimize wheelchair setup (e.g., armrest height) to encourage more neutral arm positioning.

Further Research

Conduct longitudinal studies to correlate humeral elevation patterns with the progression of shoulder pathology.

Study Limitations

  • 1
    Limited number of participants with cervical level SCI.
  • 2
    Data collected for only one or two days.
  • 3
    Calibration protocol may have induced errors due to unsupervised execution.

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