Comparison of Glenohumeral Joint Kinematics Between Manual Wheelchair Tasks and Implications on the Subacromial Space: A Biplane Fluoroscopy Study

J Electromyogr Kinesiol, 2022 · DOI: 10.1016/j.jelekin.2019.08.004 · Published: February 1, 2022

Simple Explanation

This study investigates shoulder joint (glenohumeral) movements during common manual wheelchair activities in people with spinal cord injuries using a precise imaging technique. The research aims to understand how these movements affect the space in the shoulder (subacromial space) and potentially contribute to shoulder pain. By comparing different wheelchair tasks, the study seeks to identify which movements are most likely to cause shoulder impingement, informing strategies to prevent injury.

Study Duration

Not specified

Participants

10 manual wheelchair users with spinal cord injury

Evidence Level

Not specified

Key Findings

1
Scaption was characterized by external rotation, while propulsion, sideways lean, and weight-relief raise involved internal rotation.
2
The humeral head was most superiorly positioned during the weight-relief raise.
3
There was not a consistent trend across tasks between internal rotation, superior translation, and anterior translation with reductions in the subacromial space.

Research Summary

This study accurately quantified glenohumeral kinematics during manual wheelchair tasks using fluoroscopy in individuals with spinal cord injury. The study compared glenohumeral parameters theorized to reduce the subacromial space across different tasks, including axial rotation and joint translation. The findings suggest that further research is needed to determine the likelihood of mechanical impingement during these tasks based on kinematics and subacromial space reductions.

Practical Implications

Informed Interventions

The data could inform the development of targeted physical therapy interventions to reduce the risk of shoulder impingement in manual wheelchair users.

Task Modification

Understanding which wheelchair tasks are associated with kinematic parameters can lead to modification in how tasks are performed.

Personalized Approach

The detailed kinematic data could allow for a more personalized approach to injury prevention in manual wheelchair users.

Study Limitations

1
Tasks were completed at a controlled rate, potentially affecting movement patterns.
2
Propulsion trials were conducted on a passive wheelchair ergometer, not over ground.
3
In vivo test-retest reliability could not be assessed due to a single trial per task.

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