Association between individual wheelchair skills and fitness in community-dwelling manual wheelchair users with spinal cord injuries

Community mobility and participation assessment of manual wheelchair users: a review of current techniques and challenges

According to the World Health Organization, hundreds of individuals commence wheelchair use daily, often due to an injury such as spinal cord injury or through a condition such as a stroke. However, manual wheelchair users typically experience reductions in individual community mobility and participation. In this review, articles from 2017 to 2023 were reviewed to identify means of measuring community mobility and participation of manual wheelchair users, factors that can impact these aspects, and current rehabilitation techniques for improving them. The selected articles document current best practices utilizing self-surveys, in-clinic assessments, and remote tracking through GPS and accelerometer data, which rehabilitation specialists can apply to track their patients' community mobility and participation accurately. Furthermore, rehabilitation methods such as wheelchair training programs, brain-computer interface triggered functional electric stimulation therapy, and community-based rehabilitation programs show potential to improve the community mobility and participation of manual wheelchair users. Recommendations were made to highlight potential avenues for future research.

Relationship Between Manual Wheelchair Using Skills and Upper Limb Musculoskeletal Disorders in Patients With Spinal Cord Injury: A Musculoskeletal Ultrasonography Study

OBJECTIVES

The aims of this study are to investigate the relationship between wheelchair skills and upper limb pathologies detected by ultrasound and to identify independent predictors of joint pathologies.

DESIGN

Forty-five patients who were paraplegic because of spinal cord injury were included. Demographic and clinical data were evaluated. The Spinal Cord Independence Measure III and Wheelchair Skills Test Questionnaire was administered. Shoulder, elbow, and wrist joints of both upper limbs were evaluated with ultrasound.

RESULTS

Nineteen patients (42.2%) had musculoskeletal pain in their upper limbs. The most painful area was shoulder (14, 31.1%), followed by elbow (8, 17.7%), and wrist (3, 6.6%), respectively. The Wheelchair Skills Test Questionnaire scores were worse in patients with elbow effusion ( P = 0.041) and lateral epicondyle spur formation ( P = 0.006). In the multivariate logistic regression analysis, independent predictors for joint pathologies in ultrasound were Spinal Cord Independence Measure total score, higher body mass index, older age, working with physical strength, female sex, duration of wheelchair usage, higher level of injury, and wheelchair skills (all P < 0.05).

CONCLUSIONS

Among the risk factors for joint pathologies identified in this study, the ability to use wheelchairs, which is a modifiable risk factor, should be considered in the rehabilitation process and improved.