Relationship Between Hand Contact Angle and Shoulder Loading During Manual Wheelchair Propulsion by Individuals with Paraplegia

This study investigates how the position of the hand on the wheelchair pushrim affects shoulder loading in individuals with paraplegia. Understanding these relationships can help refine wheelchair propulsion training techniques to reduce shoulder pain and injury. The research found that a more posterior initial contact angle (reaching back further) was associated with greater posterior shoulder net joint force and flexor net joint moment. A more anterior hand release angle was significantly associated with increased vertical and lateral pushrim forces and greater shoulder net joint forces. The authors suggest that while maximizing the push arc is generally good, avoiding a more anterior hand position at release is important, as it could increase shoulder load during the push phase of wheelchair propulsion.

• 1
  Increased push arc was associated with greater velocity and cycle distance, and reduced cadence.
• 2
  A more posterior initial contact angle was associated with greater posterior shoulder net joint force and greater flexor net joint moment.
• 3
  A more anterior hand release angle was significantly associated with increased vertical and greater lateral pushrim forces; greater shoulder net joint forces in all 3 planes; and greater external rotator and adductor net joint moments.