Humeral elevation workspace during daily life of adults with spinal cord injury who use a manual wheelchair compared to age and sex matched able-bodied controls

Optimizing Technical Training for Wheelchair-User Billiard Players through Modified Equipment Implementation

This study aims to enhance the effectiveness of the preparation process and the performance of wheelchair users in international billiard competitions through modified equipment. The research methods include analysis and synthesis of the scientific and methodological literature, sociological research methods (questionnaires), expert assessment methods, pedagogical research methods (observation, testing, experimentation), and methods of mathematical statistics. The results of our study are significant: Implementing our developed training program for billiards players with musculoskeletal disorders, utilizing the modified equipment (special mechanical bridge and straps for cue fixation during shots) we created in a pedagogical experiment, demonstrated a probable improvement of 36% in the technical and tactical preparedness of the athletes compared to previous years. This led to a 33% increase in players from the Ukrainian team's competition performance at the national and European Pool Championships (wheelchair division). In conclusion, implementing our developed training program, accompanied by specialized auxiliary equipment, demonstrated promising results in a pedagogical experiment. These findings underscore the potential of the modified equipment and tailored training programs to optimize sports training for individuals with musculoskeletal impairments in adaptive billiards, contributing to the continued humanization of the sport and offering an effective preparation process for the athletes.

Development and evaluation of the ARM algorithm: A novel approach to quantify musculoskeletal disorder risk factors in manual wheelchair users in the real world

This study aimed to develop and evaluate the ARM (arm repetitive movement) algorithm using inertial measurement unit (IMU) data to assess repetitive arm motion in manual wheelchair (MWC) users in real-world settings. The algorithm was tested on community data from four MWC users with spinal cord injury and compared with video-based analysis. Additionally, the algorithm was applied to in-home and free-living environment data from two and sixteen MWC users, respectively, to assess its utility in quantifying differences across activities of daily living and between dominant and non-dominant arms. The ARM algorithm accurately estimated active and resting times (>98%) in the community and confirmed asymmetries between dominant and non-dominant arm usage in in-home and free-living environment data. Analysis of free-living environment data revealed that the total resting bout time was significantly longer (P = 0.049) and total active bout time was significantly shorter (P = 0.011) for the non-dominant arm. Analysis of active bouts longer than 10 seconds showed higher total time (P = 0.015), average duration (P = 0.026), and number of movement cycles per bout (P = 0.020) for the dominant side. These findings support the feasibility of using the IMU-based ARM algorithm to assess repetitive arm motion and monitor shoulder disorder risk factors in MWC users during daily activities.

Machine-Learning-Based Methodology for Estimation of Shoulder Load in Wheelchair-Related Activities Using Wearables

There is a high prevalence of shoulder problems in manual wheelchair users (MWUs) with a spinal cord injury. How shoulder load relates to shoulder problems remains unclear. This study aimed to develop a machine-learning-based methodology to estimate the shoulder load in wheelchair-related activities of daily living using wearable sensors. Ten able-bodied participants equipped with five inertial measurement units (IMU) on their thorax, right arm, and wheelchair performed activities exemplary of daily life of MWUs. Electromyography (EMG) was recorded from the long head of the biceps and medial part of the deltoid. A neural network was trained to predict the shoulder load based on IMU and EMG data. Different cross-validation strategies, sensor setups, and model architectures were examined. The predicted shoulder load was compared to the shoulder load determined with musculoskeletal modeling. A subject-specific biLSTM model trained on a sparse sensor setup yielded the most promising results (mean correlation coefficient = 0.74 ± 0.14, relative root-mean-squared error = 8.93% ± 2.49%). The shoulder-load profiles had a mean similarity of 0.84 ± 0.10 over all activities. This study demonstrates the feasibility of using wearable sensors and neural networks to estimate the shoulder load in wheelchair-related activities of daily living.

Inertial Measurement Unit-Derived Ergonomic Metrics for Assessing Arm Use in Manual Wheelchair Users With Spinal Cord Injury: A Preliminary Report

Background:

Individuals with spinal cord injury (SCI) who use manual wheelchairs (MWCs) have a higher rate of rotator cuff pathology progression than able-bodied individuals.

Objectives:

This study aimed to test the ability of risk and recovery metrics of arm use to differentiate between (1) MWC users with SCI and matched able-bodied participants (cross-sectional matched-sample study) and (2) MWC users with rotator cuff pathology progression over 1 year from those without pathology progression (longitudinal study).

Methods:

Thirty-four MWC users and 34 age- and sex-matched able-bodied individuals were recruited. Upper arm risk (humeral elevation >60°) and recovery (static ≥5 seconds and humeral elevation <40°) metrics were calculated from wireless inertial measurement units (IMUs) worn on the upper arms and torso in the free-living environment. Two separate magnetic resonance imaging studies were completed and assessed for a subset of 16 MWC users approximately 1 year apart.

Results:

The frequency of risk events (p = .019), summated duration of recovery events (p = .025), and duration of each recovery event (p = .003) were higher for MWC users than able-bodied participants. The summated duration of risk events (p = .047), frequency of risk events (p = .027), and risk to recovery ratio (p = .02) were higher and the summated duration of recovery events (p = .036) and frequency of recovery events (p = .047) were lower for MWC users with rotator cuff pathology progression (n = 5) compared to those without progression (n = 11).

Conclusion:

IMU-derived metrics quantifying arm use at postures >60° and risk to recovery ratios may provide insights of potential risk factors for rotator cuff pathology progression.

The Influence of Sex on Upper Extremity Joint Dynamics in Pediatric Manual Wheelchair Users With Spinal Cord Injury

INTRODUCTION

Manual wheelchair propulsion is a physically demanding task associated with upper extremity pain and pathology. Shoulder pain is reported in over 25% of pediatric manual wheelchairs users, and this number rises over the lifespan. Upper extremity biomechanics in adults has been associated with shoulder pain and pathology; however, few studies have investigated upper extremity joint dynamics in children. Furthermore, sex may be a critical factor that is currently unexplored with regard to pediatric wheelchair mobility.

OBJECTIVES

To investigate differences in upper extremity joint dynamics between pediatric male and female manual wheelchair users with spinal cord injury (SCI) during wheelchair propulsion.

METHODS

Novel instrumented wheelchair hand-rims synchronized with optical motion capture were used to acquire upper extremity joint dynamics of 20 pediatric manual wheelchair users with SCI (11 males, 9 females). Thorax, sternoclavicular, acromioclavicular, glenohumeral, elbow, and wrist joint kinematics and kinetics were calculated during wheelchair propulsion. Linear mixed models were used to assess differences between sexes.

RESULTS

Females exhibited significantly greater peak forearm pronation (p = .007), normalized wrist lateral force (p = .03), and normalized elbow posterior force (p = .04) than males. Males exhibited significantly greater peak sternoclavicular joint retraction (p < .001) than females. No significant differences between males and females were observed for the glenohumeral joint (p > .012).

CONCLUSION

This study found significant differences in upper extremity joint dynamics between sexes during manual wheelchair propulsion. Our results underscore the importance of considering sex when evaluating pediatric wheelchair mobility and developing comprehensive wheelchair training interventions for early detection and prevention of upper extremity pain and pathology.