TY - JOUR
T1 - Comparing supraspinatus to acromion proximity and kinematics of the shoulder and thorax between manual wheelchair propulsion styles
T2 - A pilot study
AU - Madansingh, Stefan I.
AU - Fortune, Emma
AU - Morrow, Melissa M.
AU - Zhao, Kristin D.
AU - Cloud-Biebl, Beth A.
N1 - Funding Information:
Funded by the Mayo Clinic Rehabilitation Medicine Research Center, Craig H. Neilsen Foundation for Spinal Cord Injury Care and Research Honoring Robert D. Brown Jr., M.D. CT bone model funded by NIH K01 HD042491 (P. Ludewig, University of Minnesota). The authors would like to thank current and past members of the Assistive and Restorative Technology lab who supported the project, especially Ryan Breighner who developed the first version of the CT model-based subacromial space estimating tool, and the support provided by the staff of the Division of Biomedical Statistics and Informatics at Mayo Clinic.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/4
Y1 - 2020/4
N2 - Background: Repetitive glenohumeral joint movement during manual wheelchair propulsion has been associated with shoulder pain in individuals with spinal cord injury. Clinical guidelines for shoulder health maintenance encourage semi-circular over arc propulsion to reduce loading frequency. This study aimed to determine the difference in estimated supraspinatus to acromion compression risk, and shoulder, thorax kinematics between (1) arc and semi-circular propulsion; and (2) self-selected and coached strategies. Methods: Shoulder and thorax kinematics were captured during wheelchair propulsion, noting individually self-selected styles. Participants were then coached to perform the other style(s) of interest, arc and/or semi-circular. CT bone models of the humerus and scapula were animated using glenohumeral kinematics to estimate the minimum distance between the supraspinatus humeral attachment and the acromion. Compression risk was defined as the proportion of each propulsion phase where the minimum distance fell below 5 mm. Comparisons were made between conditions evaluating compression risk, minimum distances and kinematics at events throughout propulsion. Findings: Ten individuals with spinal cord injury (9 male) participated. Arc and semi-circular propulsion did not significantly differ in compression risk or minimum distance across propulsion phases. Self-selected styles yielded lower compression risk and larger proximity values compared to coached styles. Glenohumeral horizontal abduction and thorax flexion differed between arc and semi-circular propulsion. Multiple glenohumeral and humerothoracic differences emerged between self-selected and coached conditions. Interpretation: Supraspinatus compression was observed during both arc and semi-circular propulsion, suggesting risk may be unavoidable in this task. Self-selected styles yield less risk, likely related to coached style unfamiliarity.
AB - Background: Repetitive glenohumeral joint movement during manual wheelchair propulsion has been associated with shoulder pain in individuals with spinal cord injury. Clinical guidelines for shoulder health maintenance encourage semi-circular over arc propulsion to reduce loading frequency. This study aimed to determine the difference in estimated supraspinatus to acromion compression risk, and shoulder, thorax kinematics between (1) arc and semi-circular propulsion; and (2) self-selected and coached strategies. Methods: Shoulder and thorax kinematics were captured during wheelchair propulsion, noting individually self-selected styles. Participants were then coached to perform the other style(s) of interest, arc and/or semi-circular. CT bone models of the humerus and scapula were animated using glenohumeral kinematics to estimate the minimum distance between the supraspinatus humeral attachment and the acromion. Compression risk was defined as the proportion of each propulsion phase where the minimum distance fell below 5 mm. Comparisons were made between conditions evaluating compression risk, minimum distances and kinematics at events throughout propulsion. Findings: Ten individuals with spinal cord injury (9 male) participated. Arc and semi-circular propulsion did not significantly differ in compression risk or minimum distance across propulsion phases. Self-selected styles yielded lower compression risk and larger proximity values compared to coached styles. Glenohumeral horizontal abduction and thorax flexion differed between arc and semi-circular propulsion. Multiple glenohumeral and humerothoracic differences emerged between self-selected and coached conditions. Interpretation: Supraspinatus compression was observed during both arc and semi-circular propulsion, suggesting risk may be unavoidable in this task. Self-selected styles yield less risk, likely related to coached style unfamiliarity.
KW - Shoulder
KW - Spinal cord injury
KW - Subacromial space
KW - Wheelchair propulsion
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U2 - 10.1016/j.clinbiomech.2020.01.016
DO - 10.1016/j.clinbiomech.2020.01.016
M3 - Article
C2 - 32120286
AN - SCOPUS:85080076220
SN - 0268-0033
VL - 74
SP - 42
EP - 50
JO - Clinical Biomechanics
JF - Clinical Biomechanics
ER -