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Mechanical load on the upper extremity during wheelchair activities
Stefan Van Drongelen1, Lucas H Van der Woude, Thomas W Janssen
1Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands.
Archives of Physical Medicine and Rehabilitation
|June 15, 2005
Summary
Wheelchair users experience high joint moments during curb negotiation and weight-relief lifting, potentially increasing long-term joint damage risk. Elbow extension moments are lower in tetraplegia than paraplegia.
Area of Science:
- Biomechanics
- Rehabilitation Engineering
- Human Movement Science
Background:
- Wheelchair activities can impose significant loads on upper limb joints.
- Understanding these loads is crucial for preventing joint injuries in wheelchair users.
Purpose of the Study:
- To quantify net joint moments at the glenohumeral (shoulder) and elbow joints during various wheelchair activities.
- To compare these moments across different activities and participant groups (able-bodied, paraplegia, tetraplegia).
Main Methods:
- Kinematic and force data were collected during daily living wheelchair tasks.
- An inverse dynamics model was used to calculate joint moments.
- Participants included able-bodied individuals, and those with paraplegia and tetraplegia.
Main Results:
- Peak shoulder and elbow moments were highest during curb negotiation and weight-relief lifting.
- These high moments were significantly greater than during level propulsion, reaching, or slope riding.
- Elbow extension moments were notably lower in individuals with tetraplegia compared to those with paraplegia.
Conclusions:
- Weight-relief lifting and curb negotiation generate substantial joint moments, exceeding those from typical wheelchair propulsion.
- The cumulative effect of these high-frequency, high-duration loads may pose a considerable risk for long-term joint damage.
- Findings highlight the need for strategies to mitigate joint stress during demanding wheelchair tasks.