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Valencia OD, Danes-Daetz C, Haro S, Didyk MP, Rossato M, Benavides P, Guzman-Venegas R. Electromyographic and kinematic parameters of the shoulder in wheelchair rugby players: case reports. Res Sports Med 2024; 32:537-544. [PMID: 36578156 DOI: 10.1080/15438627.2022.2161903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022]
Abstract
Wheelchair rugby was created as part of the rehabilitation for patients with spinal cord injury. The biomechanical analysis of wheelchair propulsion (WP) in these athletes seems to be a key element to understand the reasons behind musculoskeletal injuries. This case reports study aimed to describe the electromyographic activity and kinematic parameters of the shoulder during the propulsion phases on the wheelchair in two Paralympic rugby players (A1 and A2) with spinal cord injury. Myoelectric activity (three portions of the deltoid, biceps and triceps brachii) and kinematics of the shoulder were assessed during the push (PP) and recovery (RP) phases. These variables were calculated considering ten propulsion cycles by each athlete. The results showed a different muscle activation between players, A1 described a high average amplitude of the anterior deltoid (PP = 58.44 ± 16.35%MVC; RP = 43.16 ± 13.48%MVC) in both propulsion phases, while A2 generated high average activity of triceps brachii (29.28 ± 10.63%MVC) and middle deltoid (46.53 ± 14.48%MVC), during PP and RP, respectively. At the same time, the player with a C7-T1 spinal cord injury (A2) showed a higher range of motion in the three plans, considering both propulsion phases.
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Affiliation(s)
- Oscar D Valencia
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
| | - Claudia Danes-Daetz
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
- Institute of Sport, Exercise and Health, UCL, London, UK
| | - Sofía Haro
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
| | - M Pía Didyk
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
| | - M Rossato
- Human Performance Laboratory, Physical Education and Physiotherapy Faculty, Federal University of Amazonas, Manaus, Brazil
| | - Pablo Benavides
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andrés Bello, Chile
| | - Rodrigo Guzman-Venegas
- Laboratorio Integrativo de Biomecánica y Fisiología del Esfuerzo, Escuela de Kinesiología, Facultad de Medicina, Universidad de los Andes, Chile
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Skedros JG, Cronin JT, Finlinson ED, Langston TD, Adondakis MG. Manual wheelchair use leads to a series of failed shoulder replacements: A case report and literature review. Clin Case Rep 2022; 10:e06374. [PMID: 36188047 PMCID: PMC9508804 DOI: 10.1002/ccr3.6374] [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: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 11/12/2022] Open
Abstract
Manual wheelchair users place high stress on their shoulders. We describe a 69-year-old male who developed end-stage shoulder osteoarthritis from chronic manual wheelchair (MW) use. Three prosthetic total shoulder replacements failed, reflecting his refusal to transition to an electric wheelchair. MW use must be avoided in some of these patients.
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Affiliation(s)
- John G. Skedros
- Department of Orthopaedic SurgeryThe University of UtahSalt Lake CityUtahUSA
- Utah Orthopaedic SpecialistsSalt Lake CityUtahUSA
- Intermountain Medical CenterSalt Lake CityUtahUSA
| | | | | | - Tanner D. Langston
- Department of RadiologyWest Virginia UniversityMorgantownWest VirginiaUSA
| | - Micheal G. Adondakis
- Department of RadiologyBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
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Jahanian O, Gaglio A, Cho CC, Muqeet V, Smith R, Morrow MMB, Hsiao-Wecksler ET, Slavens BA. Hand-rim biomechanics during geared manual wheelchair propulsion over different ground conditions in individuals with spinal cord injury. J Biomech 2022; 142:111235. [PMID: 35947887 PMCID: PMC10765479 DOI: 10.1016/j.jbiomech.2022.111235] [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: 01/16/2022] [Revised: 06/29/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022]
Abstract
Geared manual wheelchair wheels, a recently developed alternative propulsion mechanism, have the potential to alleviate the high upper extremity demands required for wheelchair propulsion and help decrease the risk of secondary injuries in manual wheelchair users. The objective of this study was to investigate the effects of using geared manual wheelchairs on hand-rim biomechanics of wheelchair propulsion in individuals with spinal cord injury (SCI). Seven manual wheelchair users with SCI propelled their wheelchairs equipped with geared wheels over tile, carpet, and up a ramp in low gear (gear ratio 1.5:1) and standard gear (gear ratio 1:1) conditions. Hand-rim kinetics and stroke cycle characteristics were measured using a custom instrumented geared wheel. Using the geared wheels in the low gear condition, propulsion speed (P = 0.013), peak resultant force (P = 0.005), peak propulsive moment (P < 0.006), and peak rate of rise of the resultant force (P = 0.035) decreased significantly in comparison with the standard gear condition. The significant increase in the number of stroke cycles when normalized to distance (P = 0.004) and decrease in the normalized integrated moment (P = 0.030) indicated that although a higher number of stroke cycles are required for travelling a given distance in the low gear than the standard gear condition, the low gear condition might be less demanding for the upper extremity. These results suggest that geared wheels could be a useful technology for manual wheelchair users to independently accomplish strenuous propulsion tasks including mobility on carpeted floors and ramp ascension, while reducing the risk factors contributing to the incidence of secondary upper extremity injuries.
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Affiliation(s)
- Omid Jahanian
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
| | - Alan Gaglio
- Department of Mechanical Science & Engineering, University of Illinois at Urbana-Champaign, IL, USA
| | - Chris C Cho
- College of Health Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Vaishnavi Muqeet
- Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Roger Smith
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Melissa M B Morrow
- Department of Nutrition, Metabolism & Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Brooke A Slavens
- Department of Rehabilitation Sciences and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Rouvier T, Louessard A, Simonetti E, Hybois S, Bascou J, Pontonnier C, Pillet H, Sauret C. Manual wheelchair biomechanics while overcoming various environmental barriers: A systematic review. PLoS One 2022; 17:e0269657. [PMID: 35737733 PMCID: PMC9223621 DOI: 10.1371/journal.pone.0269657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
During manual wheelchair (MWC) locomotion, the user's upper limbs are subject to heavy stresses and fatigue because the upper body is permanently engaged to propel the MWC. These stresses and fatigue vary according to the environmental barriers encountered outdoors along a given path. This study aimed at conducting a systematic review of the literature assessing the biomechanics of MWC users crossing various situations, which represent physical environmental barriers. Through a systematic search on PubMed, 34 articles were selected and classified according to the investigated environmental barriers: slope; cross-slope; curb; and ground type. For each barrier, biomechanical parameters were divided into four categories: spatiotemporal parameters; kinematics; kinetics; and muscle activity. All results from the different studies were gathered, including numerical data, and assessed with respect to the methodology used in each study. This review sheds light on the fact that certain situations (cross-slopes and curbs) or parameters (kinematics) have scarcely been studied, and that a wider set of situations should be studied. Five recommendations were made at the end of this review process to standardize the procedure when reporting materials, methods, and results for the study of biomechanics of any environmental barrier encountered in MWC locomotion: (i) effectively reporting barriers' lengths, grades, or heights; (ii) striving for standardization or a report of the approach conditions of the barrier, such as velocity, especially on curbs; (iii) reporting the configuration of the used MWC, and if it was fitted to the subject's morphology; (iv) reporting rotation sequences for the expression of moments and kinematics, and when used, the definition of the musculoskeletal model; lastly (v) when possible, reporting measurement uncertainties and model reconstruction errors.
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Affiliation(s)
- Théo Rouvier
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Paris, France
| | - Aude Louessard
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Paris, France
| | - Emeline Simonetti
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Paris, France
- Centre d’Études et de Recherche sur l’Appareillage des Handicapés, Institution Nationale des Invalides, Créteil, France
| | - Samuel Hybois
- Complexité Innovation Activités Motrices et Sportives, Faculté des Sciences du Sport, Université Paris-Saclay, Orsay, France
| | - Joseph Bascou
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Paris, France
- Centre d’Études et de Recherche sur l’Appareillage des Handicapés, Institution Nationale des Invalides, Créteil, France
| | - Charles Pontonnier
- Université de Rennes, Centre National de la Recherche Scientifique, Institut National de Recherche en Informatique et en Automatique, Institut de Recherche en Informatique et Systèmes Aléatoires–Unité Mixte de Recherche 6074, Rennes, France
| | - Hélène Pillet
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Paris, France
| | - Christophe Sauret
- Institut de Biomécanique Humaine Georges Charpak, Arts et Métiers Institute of Technology, Paris, France
- Centre d’Études et de Recherche sur l’Appareillage des Handicapés, Institution Nationale des Invalides, Créteil, France
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