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Togni R, Zemp R, Kirch P, Plüss S, Vegter RJK, Taylor WR. Steering-by-leaning facilitates intuitive movement control and improved efficiency in manual wheelchairs. J Neuroeng Rehabil 2023; 20:145. [PMID: 37884944 PMCID: PMC10605392 DOI: 10.1186/s12984-023-01265-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Manual wheelchair propulsion is widely accepted to be biomechanically inefficient, with a high prevalence of shoulder pain and injuries among users. Directional control during wheelchair movement is a major, yet largely overlooked source of energy loss: changing direction or maintaining straightforward motion on tilted surfaces requires unilateral braking. This study evaluates the efficiency of a novel steering-by-leaning mechanism that guides wheelchair turning through upper body leaning. METHODS 16 full-time wheelchair users and 15 able-bodied novices each completed 12 circuits of an adapted Illinois Agility Test-course that included tilted, straight, slalom, and 180° turning sections in a prototype wheelchair at a self-selected functional speed. Trials were alternated between conventional and steering-by-leaning modes while propulsion forces were recorded via instrumented wheelchair wheels. Time to completion, travelled distance, positive/negative power, and work done, were all calculated to allow comparison of the control modes using repeated measures analysis of variance. RESULTS Substantial average energy reductions of 51% (able-bodied group) and 35% (wheelchair user group) to complete the task were observed when using the steering-by-leaning system. Simultaneously, able-bodied subjects were approximately 23% faster whereby completion times did not differ for wheelchair users. Participants in both groups wheeled some 10% further with the novel system. Differences were most pronounced during turning and on tilted surfaces where the steering-by-leaning system removed the need for braking for directional control. CONCLUSIONS Backrest-actuated steering systems on manual wheelchairs can make a meaningful contribution towards reducing shoulder usage while contributing to independent living. Optimisation of propulsion techniques could further improve functional outcomes.
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Affiliation(s)
- Reto Togni
- Laboratory for Movement Biomechanics, ETH Zürich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Roland Zemp
- Laboratory for Movement Biomechanics, ETH Zürich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Pleuni Kirch
- Human Movement Sciences, University of Groningen, Groningen, Netherlands
| | - Stefan Plüss
- Laboratory for Movement Biomechanics, ETH Zürich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Riemer J K Vegter
- Human Movement Sciences, University of Groningen, Groningen, Netherlands
| | - William R Taylor
- Laboratory for Movement Biomechanics, ETH Zürich, Gloriastrasse 37/39, 8092, Zurich, Switzerland.
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Biduski GM, Knihs DA, Nery de Oliveira S, Hoinaski LP, Rossato M, Freitas CDLR. Magnitude and direction of elbow torque asymmetries in manual wheelchair users. Front Sports Act Living 2023; 5:1239626. [PMID: 37745200 PMCID: PMC10514472 DOI: 10.3389/fspor.2023.1239626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
The aims of the present study are to investigate the magnitude and direction of the elbow torque asymmetries in manual wheelchair users and to verify the agreement levels of the asymmetry's direction between different velocities and contraction modes in the isokinetic test. The sample was composed of 14 manual wheelchair users (four women, 10 men). The peak torque of the elbow flexors and extensors were measured on the dominant and non-dominant limbs, using a set of concentric/eccentric contractions at speeds of 60° s-1 and 180° s-1. Asymmetries were calculated by a specific equation, and the levels of agreement of the asymmetry's direction were calculated using Kappa coefficient. The main results showed a large variability in the magnitude of the asymmetries, ranging from -73.1% (ND) to 59.9% (D) between participants. The agreement levels of the elbow flexors and extensors between the different contraction modes were great (k = 0.71-0.85) for most of the velocities [except for flexors of 60° s-1 (k = 0.29)], but the agreement levels were only slight to fair (k = 0.16-0.31) for most of the contraction modes when comparing between velocities [except for flexors eccentric (k = 0.71)]. In conclusion, the elbow torque asymmetries are highly variable between subjects in terms of magnitude. In addition, in general, the limb favored by the asymmetry is the same when comparing between velocities, but not when comparing between contraction modes.
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Affiliation(s)
- Grazieli Maria Biduski
- Laboratory of Biomechanics, Sport Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Débora Aparecida Knihs
- Laboratory of Biomechanics, Sport Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Silas Nery de Oliveira
- Laboratory of Biomechanics, Sport Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Laís Peixoto Hoinaski
- Laboratory of Biomechanics, Sport Center, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Mateus Rossato
- Laboratory of Human Performance, Faculty of Physical Education and Physiotherapy, Federal University of Amazonas, Manaus, Brazil
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Briley SJ, O'Brien TJ, Oh YT, Vegter RJK, Chan M, Mason BS, Goosey-Tolfrey VL. Wheelchair rugby players maintain sprint performance but alter propulsion biomechanics after simulated match play. Scand J Med Sci Sports 2023; 33:1726-1737. [PMID: 37278319 DOI: 10.1111/sms.14423] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023]
Abstract
The study aimed to explore the influence of a sports-specific intermittent sprint protocol (ISP) on wheelchair sprint performance and the kinetics and kinematics of sprinting in elite wheelchair rugby (WR) players with and without spinal cord injury (SCI). Fifteen international WR players (age 30.3 ± 5.5 years) performed two 10-s sprints on a dual roller wheelchair ergometer before and immediately after an ISP consisting of four 16-min quarters. Physiological measurements (heart rate, blood lactate concentration, and rating of perceived exertion) were collected. Three-dimensional thorax and bilateral glenohumeral kinematics were quantified. Following the ISP, all physiological parameters significantly increased (p ≤ 0.027), but neither sprinting peak velocity nor distance traveled changed. Players propelled with significantly reduced thorax flexion and peak glenohumeral abduction during both the acceleration (both -5°) and maximal velocity phases (-6° and 8°, respectively) of sprinting post-ISP. Moreover, players exhibited significantly larger mean contact angles (+24°), contact angle asymmetries (+4%), and glenohumeral flexion asymmetries (+10%) during the acceleration phase of sprinting post-ISP. Players displayed greater glenohumeral abduction range of motion (+17°) and asymmetries (+20%) during the maximal velocity phase of sprinting post-ISP. Players with SCI (SCI, n = 7) significantly increased asymmetries in peak power (+6%) and glenohumeral abduction (+15%) during the acceleration phase post-ISP. Our data indicates that despite inducing physiological fatigue resulting from WR match play, players can maintain sprint performance by modifying how they propel their wheelchair. Increased asymmetry post-ISP was notable, which may be specific to impairment type and warrants further investigation.
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Affiliation(s)
- Simon J Briley
- Human Sciences Research Centre, University of Derby, Derby, UK
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Thomas J O'Brien
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Yim-Taek Oh
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Riemer J K Vegter
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
- Department of Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mui Chan
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Barry S Mason
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
| | - Victoria L Goosey-Tolfrey
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire, UK
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Houry M, Bonnard M, Tourny C, Gilliaux M. Kinematic, electromyographic and isokinetic measurements for the management of shoulder subacromial pain syndrome: A systematic review. Clin Biomech (Bristol, Avon) 2023; 107:106029. [PMID: 37348207 DOI: 10.1016/j.clinbiomech.2023.106029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/24/2023] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Subacromial shoulder pain syndrome is a very common and challenging musculoskeletal disorder. Kinematics, electromyographic muscle activity and isokinetic dynamometry are promising non-invasive movement analysis tools to improve understanding of this condition. No review has combined their results to provide a better understanding of the effects of subacromial pain syndrome on shoulder movement. This systematic review aimed to synthesise the associations between exposure to shoulder pain due to subacromial pain syndromes or subacromial impingement and changes in shoulder movement measures. METHODS The databases were Scholar google, Pubmed, Science Direct, Scopus and the Cochrane Library. We included studies that observed the association of the presence of subacromial pain syndromes or subacromial impingement with changes in shoulder motion measures. FINDINGS Seventeen studies with 943 participants were included. The main kinematic change was a lower scapular posterior during abduction in the subacromial pain syndrome group with a "low" level of evidence (standardised mean difference = -0.61, 95% confidence interval [-0.80; -0.43]). The main electromyographic change was an earlier onset of activation of the upper trapezius in the subacromial pain syndrome group, with a "moderate" level of evidence (standardised mean difference = 1.01, 95% confidence interval: [-2.97; 0.96]). The main isokinetic change was a lower peak internal rotator torque in the subacromial pain syndrome group, with a 'low' level of evidence (standardised mean difference = -0.41, 95% confidence interval: [-0.53; -0.29]). INTERPRETATION The variables measured during movement are associated with subacromial pain syndrome or subacromial impingement syndrome. Consistency between the results supports the importance of scapula biomechanics measurements in these conditions.
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Affiliation(s)
- Maxime Houry
- CETAPS EA3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, F-76821 Mont-Saint-Aignan, France; Clinical Research Departement, La Musse Hospital, La Renaissance Sanitaire Fundation, Saint Sébastien de Morsent, France.
| | | | - Claire Tourny
- CETAPS EA3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, F-76821 Mont-Saint-Aignan, France
| | - Maxime Gilliaux
- CETAPS EA3832, Research Center for Sports and Athletic Activities Transformations, University of Rouen Normandy, F-76821 Mont-Saint-Aignan, France; Clinical Research Departement, La Musse Hospital, La Renaissance Sanitaire Fundation, Saint Sébastien de Morsent, France
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Liu T, Wassell N, Liu J, Zhang M. Mapping Research Trends of Adapted Sport from 2001 to 2020: A Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12644. [PMID: 36231944 PMCID: PMC9564994 DOI: 10.3390/ijerph191912644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To identify the research landscape in terms of keywords, annual outputs, journals, countries, and institutions and explore the hot topics and prospects regarding adapted sport research. MATERIALS AND METHODS Publications designated as "article" on adapted sport retrieved from the Web of Science Core Collection. VOSviewer 1.6.11, Citespace, and Bibliometrix in R Studio were applied for the bibliometric analyses. RESULTS A total of 1887 articles were identified. Over the past two decades, athletic performance, sociology/psychology, and rehabilitation were extensively investigated. Basketball, soccer, and swimming were the three most focused adapted sports. Researchers showed a growing interest in submitting their studies to sport science, rehabilitation, and sociological journals. Adapted sport research was more common in developed countries and regions. The UK contributed most publications accounting for about 20% of the total publications. CONCLUSIONS With the growth of publications concerning adapted sport, the bibliometric analysis presented an overview of collaboration, trends, and hotspots in the field.
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Affiliation(s)
- Tao Liu
- School of Kinesiology, Beijing Sport University, Beijing 100084, China
| | - Nicole Wassell
- Department of Physical Education and Health Education, Springfield College, Springfield, MA 01109, USA
| | - John Liu
- Department of Physical Education and Health Education, Springfield College, Springfield, MA 01109, USA
| | - Meiqi Zhang
- Department of Physical Education and Health Education, Springfield College, Springfield, MA 01109, USA
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Blauwet CA, Chakraverty J, Derman W, Idrisova G, Martin P, Miller SC, Morrissey D, Webborn N. Shoulder Pain, Function, and Ultrasound-Determined Structure in Elite Wheelchair-Using Para Athletes: An Observational Study. Med Sci Sports Exerc 2022; 54:896-904. [PMID: 35081095 DOI: 10.1249/mss.0000000000002875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine the relationship between shoulder pain, physical examination, and tissue pathology in manual wheelchair users competing in elite sport. METHODS Eighty elite para athletes who used a manual wheelchair for daily mobility were recruited from international track (n = 40), field (n = 19), and powerlifting (n = 21) competitions. Athletes were surveyed regarding shoulder pain history and symptoms (Wheelchair User's Shoulder Pain Index (WUSPI)), whereas independent blind observers measured signs (Physical Examination of the Shoulder Scale (PESS)) and tissue pathology (Ultrasound Shoulder Pathology Rating Scale (USPRS)). Relationships between measures for the total cohort and for subgroups defined by sporting discipline were calculated. RESULTS A large proportion of athletes reported a history of upper limb pain (39% dominant and 35% nondominant). For the total cohort, WUSPI score was 22.3 ± 26.9, PESS score was 7.4 ± 6.7, and USPRS score was 5.2 ± 4.0. There were no USPRS score differences between athlete subgroups; however, track athletes had lower WUSPI and PESS scores, especially compared with field athletes. The first principal component explained most of the variance in the WUSPI and PESS, which were strongly correlated (r = 0.71), and the second orthogonal component explained the USPRS, which did not correlate with either the PESS (r = 0.21) or WUSPI (r = 0.20). Subgroup analysis showed that track athletes had lower symptom scores for a given physical examination score. CONCLUSIONS Elite para athletes who use manual wheelchairs for daily mobility have a high prevalence of shoulder symptoms, positive signs on physical examination, and ultrasound-determined tissue pathology. Ultrasound-determined tissue pathology does not correlate with symptoms or signs. This information can help to guide clinicians in managing shoulder problems in this athlete population at high risk of injury.
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Affiliation(s)
| | - Julian Chakraverty
- University Hospitals of Bristol & Weston NHS Foundation Trust, Bristol, UNITED KINGDOM
| | | | | | - Paul Martin
- English Institute of Sport, Manchester Institute of Health and Performance, Manchester, UNITED KINGDOM
| | - Stuart C Miller
- Sport and Exercise Medicine, Queen Mary University of London, London, UNITED KINGDOM
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Briley SJ, Vegter RJK, Goosey-Tolfrey VL, Mason BS. Alterations in shoulder kinematics are associated with shoulder pain during wheelchair propulsion sprints. Scand J Med Sci Sports 2022; 32:1213-1223. [PMID: 35620900 PMCID: PMC9545165 DOI: 10.1111/sms.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/27/2022] [Accepted: 04/04/2022] [Indexed: 12/02/2022]
Abstract
The study purpose was to examine the biomechanical characteristics of sports wheelchair propulsion and determine biomechanical associations with shoulder pain in wheelchair athletes. Twenty wheelchair court‐sport athletes (age: 32 ± 11 years old) performed one submaximal propulsion trial in their sports‐specific wheelchair at 1.67 m/s for 3 min and two 10 s sprints on a dual‐roller ergometer. The Performance Corrected Wheelchair User's Shoulder Pain Index (PC‐WUSPI) assessed shoulder pain. During the acceleration phase of wheelchair sprinting, participants propelled with significantly longer push times, larger forces, and thorax flexion range of motion (ROM) than both the maximal velocity phase of sprinting and submaximal propulsion. Participants displayed significantly greater peak glenohumeral abduction and scapular internal rotation during the acceleration phase (20 ± 9° and 45 ± 7°) and maximal velocity phase (14 ± 4° and 44 ± 7°) of sprinting, compared to submaximal propulsion (12 ± 6° and 39 ± 8°). Greater shoulder pain severity was associated with larger glenohumeral abduction ROM (r = 0.59, p = 0.007) and scapular internal rotation ROM (r = 0.53, p = 0.017) during the acceleration phase of wheelchair sprinting, but with lower peak glenohumeral flexion (r = −0.49, p = 0.030), peak abduction (r = −0.48, p = 0.034), and abduction ROM (r = −0.44, p = 0.049) during the maximal velocity phase. Biomechanical characteristics of wheelchair sprinting suggest this activity imposes greater mechanical stress than submaximal propulsion. Kinematic associations with shoulder pain during acceleration are in shoulder orientations linked to a reduced subacromial space, potentially increasing tissue stress.
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Affiliation(s)
- Simon J Briley
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Human Sciences Research Centre, University of Derby, Derby, UK
| | - Riemer J K Vegter
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Victoria L Goosey-Tolfrey
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Barry S Mason
- Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Mayrhuber L, Rietveld T, de Vries W, van der Woude LHV, de Groot S, Vegter RJK. A Scoping Review on Shoulder Injuries of Wheelchair Tennis Players: Potential Risk-Factors and Musculoskeletal Adaptations. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:862233. [PMID: 36189002 PMCID: PMC9397987 DOI: 10.3389/fresc.2022.862233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022]
Abstract
Wheelchair tennis players are prone to develop shoulder injuries, due to the combination of wheelchair propulsion, overhead activities and daily wheelchair activities. A methodical literature search was conducted to identify articles on shoulder complaints in wheelchair tennis, wheelchair sports and tennis. The aims were to identify (1) type of shoulder complaints; (2) possible risk factors for the development of shoulder injuries; (3) musculoskeletal adaptations in the shoulder joint in wheelchair tennis players. Fifteen papers were included in this review, five on wheelchair tennis, three on wheelchair sports and seven on tennis. Type of shoulder complaints were acromioclavicular pathology, osteoarthritic changes, joint effusion and rotator cuff tears. Possible risk factors for the development of shoulder injuries in wheelchair tennis are overhead movements, repetitive activation of the anterior muscle chain and internal rotators, as well as a higher spinal cord injury level. Muscular imbalance with higher values for the internal rotators, increase in external range of motion, decrease in internal range of motion and reduced total arc of motion were the most common proposed musculoskeletal adaptations due to an unbalanced load. These presented risk factors and musculoskeletal adaptations might help researchers, coaches and wheelchair tennis players to prevent shoulder injuries.
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Affiliation(s)
- Laura Mayrhuber
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Thomas Rietveld
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- *Correspondence: Thomas Rietveld
| | | | - Lucas H. V. van der Woude
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Sport Exercise & Health Sciences, Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sonja de Groot
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, Netherlands
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Riemer J. K. Vegter
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- School of Sport Exercise & Health Sciences, Peter Harrison Centre for Disability Sport, Loughborough University, Loughborough, United Kingdom
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Musculoskeletal Pain Due to Wheelchair Use: A Systematic Review and Meta-Analysis. Pain Ther 2021; 10:973-984. [PMID: 34387846 PMCID: PMC8586284 DOI: 10.1007/s40122-021-00294-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/12/2021] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Wheelchair users are at a high risk of experiencing non-neuropathic pain of musculoskeletal origin as a result of being wheelchair-bound. The aim of this systematic review was to establish the prevalence of musculoskeletal pain in wheelchair users that is attributable to wheelchair use, and to describe the different pain syndromes and discuss risk factors and management options. METHODS After a systematic MEDLINE search, we identified 40 papers eligible for inclusion. RESULTS The pooled prevalence of musculoskeletal pain at any location was 50% (95% CI 33-67%). The most common pain syndrome was shoulder pain (pooled prevalence 44%, 95% CI 36-52%). Wheelchair users were 5.8 times as likely to suffer from shoulder pain as controls (95% CI 2.7-12.2, p < 0.0001). Other pain syndromes included neck, elbow, wrist, hand and low back pain. Older age and increased duration of wheelchair use were the most significant determinants of pain in wheelchair users. CONCLUSIONS Musculoskeletal pain as a result of wheelchair use is very common amongst wheelchair users. Management of pain should follow national and international guidelines. Optimal adjustment of seating position may prevent pain, and is important to be taken into consideration.
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The Relationship between Clinical Tests, Ultrasound Findings and Selected Field-Based Wheelchair Skills Tests in a Cohort of Quadriplegic Wheelchair Rugby Athletes: A Pilot Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11094162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Manual wheelchair use may determine shoulder joint overload and rotator cuff injury. Chronic shoulder pathologies can also influence the propulsion ability of wheelchair athletes with spinal cord injury (SCI) during sport activities. However, the relationship between shoulder pathology and wheelchair performances has never been explored. Therefore, the study aimed to investigate the correlation between shoulder pathologic findings with clinical tests and ultrasonography evaluation and the results of wheelchair performance tests. Nineteen quadriplegic wheelchair rugby players were evaluated to investigate the association between clinical and ultrasound shoulder pathologic findings and their correlation with the performance of field-based selected wheelchair skills tests (WSTs). The outcome measures were the International Wheelchair Rugby Classification Score, dominant and non-dominant Physical Examination Shoulder Score, and dominant and non-dominant Ultrasound Shoulder Pathology Rating Scale (USPRS). The WST was measured at the beginning and at one-year follow-up. A statistically significant correlation was found between the time since SCI and dominant USPRS (p < 0.005). The non-dominant USPRS was strongly related to WST at the beginning (p < 0.005) and the end of the study (p < 0.05). Data suggest that the severity of the non-dominant shoulder pathology detected on the ultrasound is related to lower performance on the WST. Chronic manual wheelchair use could be responsible for dominant SCI shoulder joint and rotator cuff muscle damage, while non-dominant USPRS could be related to performance on the WST.
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Briley SJ, Vegter RJ, Goosey-Tolfrey VL, Mason BS. Scapular kinematic variability during wheelchair propulsion is associated with shoulder pain in wheelchair users. J Biomech 2020; 113:110099. [DOI: 10.1016/j.jbiomech.2020.110099] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/07/2020] [Accepted: 10/17/2020] [Indexed: 10/23/2022]
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Pinheiro LSP, Ocarino JM, Madaleno FO, Verhagen E, de Mello MT, Albuquerque MR, Andrade AGP, da Mata CP, Pinto RZ, Silva A, Resende RA. Prevalence and incidence of injuries in para athletes: a systematic review with meta-analysis and GRADE recommendations. Br J Sports Med 2020; 55:1357-1365. [PMID: 33229444 DOI: 10.1136/bjsports-2020-102823] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate prevalence, incidence and profile of musculoskeletal injuries in para athletes. DESIGN Systematic review. DATA SOURCES Searches were conducted in MEDLINE, EMBASE, AMED, SPORTSDiscus, CINAHL and hand searching. ELIGIBILITY CRITERIA Studies were considered if they reported prevalence or incidence of musculoskeletal injuries in para athletes. Study selection, data extraction and analysis followed the protocol. Meta-analyses were conducted to estimate the prevalence and incidence rate among studies and subgroup analyses investigated whether methodological quality and sample size of the studies influenced on the estimated injury prevalence and incidence. The Grading of Recommendations Assessment, Development and Evaluation system determined the strength of evidence. RESULTS Forty-two studies were included. The prevalence of musculoskeletal injuries was 40.8% (95% CI 32.5% to 49.8%). Because of imprecision, indirectness and inconsistency, the strength of evidence was very low quality. The incidence of musculoskeletal injuries was 14.3 injuries per 1000 athlete-days (95% CI 11.9 to 16.8). The strength of evidence was low quality because of imprecision and indirectness. The subgroup analyses revealed that the sample size influenced on estimated injury prevalence and methodological quality influenced on estimated incidence. Injuries were more prevalent in the shoulder, for non-ambulant para athletes, and in the lower limbs, for ambulant para athletes. SUMMARY/CONCLUSION Para athletes show high prevalence and incidence of musculoskeletal injuries. Current very low-quality and low-quality evidence suggests that future high-quality studies with systematic data collection, larger sample size and specificities of para athletes are likely to change estimates of injury prevalence and incidence in para athletes. PROSPERO REGISTRATION NUMBER CRD42020147982.
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Affiliation(s)
- Larissa Santos Pinto Pinheiro
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy. Rehabilitation Sciences Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Juliana Melo Ocarino
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy. Rehabilitation Sciences Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernanda Oliveira Madaleno
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy. Rehabilitation Sciences Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Evert Verhagen
- Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marco Túlio de Mello
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maicon Rodrigues Albuquerque
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - André Gustavo Pereira Andrade
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carla Patrícia da Mata
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rafael Zambelli Pinto
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy. Rehabilitation Sciences Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andressa Silva
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renan Alves Resende
- School of Physical Education, Physical Therapy and Occupational Therapy, Department of Physical Therapy. Rehabilitation Sciences Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Briley SJ, Vegter RJ, Tolfrey VL, Mason BS. Propulsion biomechanics do not differ between athletic and nonathletic manual wheelchair users in their daily wheelchairs. J Biomech 2020; 104:109725. [DOI: 10.1016/j.jbiomech.2020.109725] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 02/25/2020] [Accepted: 02/25/2020] [Indexed: 11/25/2022]
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