Upper-limb joint kinetics expression during wheelchair propulsion

In the wheelchair propulsion literature, it is common to report upper-limb (UL) joint kinetics to express shoulder, elbow, and wrist loads. Choosing the appropriate kinetic resolution coordinate system (CS) for UL joint forces and moments has become a laboratory-specific process. The differences that arise during interpretation may hinder a clear and broad understanding of UL joint kinetics during wheelchair propulsion. This article addresses the inconsistency of kinetic reporting in the wheelchair literature that examines the pain and injury experienced by manual wheelchair users. To highlight the variety of reporting methods in wheelchair propulsion, this article surveys peer-reviewed, published articles reporting wrist-, elbow-, or shoulder-joint intersegmental forces and moments calculated from inverse dynamics during wheelchair propulsion. To correct this inconsistency, researchers may need to standardize kinetic reporting methods to achieve a cohesive comprehension of wheelchair biomechanics. This article is provided to open discussion on the anatomical and clinical relevance of currently employed CSs and other available options, with the additional goal of providing an initial recommendation for kinetic representation during wheelchair propulsion.