Impact of Gender on Shoulder Torque and Manual Wheelchair Usage for Individuals with Paraplegia: A Preliminary Report

Top Spinal Cord Inj Rehabil, 2009 · DOI: 10.1310/sci1502-79 · Published: September 29, 2009

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

This study investigates how gender affects shoulder strength and wheelchair use in people with paraplegia. Women with spinal cord injuries are becoming more common, and their specific needs regarding shoulder strength and mobility require attention. The research found that men had significantly greater shoulder strength than women. While both genders had similar wheelchair speeds, men traveled greater distances daily. The findings suggest that women with paraplegia may experience greater strain on their shoulder muscles compared to men, potentially increasing their risk of fatigue and shoulder pain due to the demands of daily wheelchair use.

Study Duration

3-year prospective observational study

Participants

67 persons with paraplegia (60 men, 7 women)

Evidence Level

Not specified

Key Findings

1
Men had 62%–96% greater shoulder torques than women, indicating significantly higher upper body strength.
2
Men traveled significantly greater distances in their wheelchairs daily compared to women.
3
The average speed of wheelchair propulsion was similar between men and women.

Research Summary

This preliminary study examined the impact of gender on shoulder strength and community wheelchair usage in individuals with paraplegia. The results indicated significant differences in shoulder torque and daily distance traveled, with men exhibiting greater strength and mobility. The study suggests that women may experience higher relative effort in wheelchair propulsion, potentially predisposing them to shoulder pain and fatigue.

Practical Implications

Targeted Interventions

Develop tailored shoulder-strengthening programs for women with paraplegia, focusing on external rotator muscles, to improve strength and potentially increase community mobility.

Wheelchair Design

Design wheelchairs that better suit the physiology and functional needs of women with SCI to enhance propulsion efficiency and reduce shoulder strain.

Vocational Support

Provide vocational rehabilitation services that address gender-specific challenges in returning to work, considering the impact of shoulder pain and mobility limitations on employment opportunities.

Study Limitations

1
The disparity in the number of men and women tested was greater than the nationally reported gender disparity in incidence of SCI.
2
The study averaged shoulder torque of both upper extremities together and normalized that value to body weight, without investigating differences between dominant and non-dominant sides.
3
The study did not document wheelchair skills or environmental barriers in the community, potential confounders to average community wheelchair distance traveled and velocity.

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