Trunk and Shoulder Kinematic and Kinetic and Electromyographic Adaptations to Slope Increase during Motorized Treadmill Propulsion among Manual Wheelchair Users with a Spinal Cord Injury

BioMed Research International, 2015 · DOI: http://dx.doi.org/10.1155/2015/636319 · Published: January 1, 2015

Spinal Cord Injury Assistive Technology Biomechanics

Simple Explanation

This study looks at how people who use manual wheelchairs move their bodies when pushing their wheelchairs on a treadmill set at different inclines. Researchers measured movements of the trunk and shoulder, forces at the shoulder joint, and muscle activity. As the treadmill slope increased, participants leaned forward more and bent their shoulders more. The amount of force and muscle effort at the shoulder also increased with steeper slopes. The findings suggest that using slopes on a treadmill can be a way to strengthen the upper body for wheelchair users, but it needs to be done carefully to avoid injury.

Study Duration

Not specified

Participants

18 participants with spinal cord injury

Evidence Level

Level 4, Experimental Study

Key Findings

1
Forward trunk flexion and shoulder flexion increased as the slope became steeper during wheelchair propulsion on a motorized treadmill.
2
Shoulder flexion, adduction, and internal rotation moments increased with the steeper slopes, indicating greater mechanical demand.
3
Muscular demand in the pectoralis major and deltoid muscles increased as the slope of the treadmill increased.

Research Summary

The study quantified the trunk and shoulder kinematic changes along with the shoulder joint moments and electromyographic changes during manual wheelchair (MWC) propulsion on a motorized treadmill set at a self-selected natural speed on five different slopes. Overall, the MWC users with a SCI increased forward trunk flexion and peak shoulder flexion while also increasing shoulder mechanical and muscular efforts to adapt to slopes that progressively increased during simulated uphill MWC propulsion on a motorized treadmill. The study confirms that MWC users with a SCI increase forward trunk flexion and peak shoulder flexion while also increasing shoulder mechanical and muscular efforts to adapt to slopes that progressively increase during simulated uphill MWC propulsion on a motorized treadmill.

Practical Implications

High-Intensity Interval Training

Therapists may use slopes on a motorized treadmill to offer task-specific high-intensity short duration interval training programs to increase upper limb strength, particularly at the shoulders.

Cardiorespiratory Fitness Training

Therapists may offer task-specific cardiorespiratory fitness training programs when a MWC user propels on a motorized treadmill with no slope or minimal slope (<2.7∘) with minimal demands during a prolonged period of time.

Risk Management

Caution is advised when using slopes, as increased shoulder mechanical and muscular demands could trigger secondary impairments. Programs should include warm-up, cool-down, and antagonist muscle strengthening.

Study Limitations

1
Relatively small sample size (n=18) of experienced MWC users.
2
Participants used their personal wheelchairs, which may have varied optimal wheelchair positioning and configuration parameters.
3
Kinematic and kinetic and electromyographic variables solely focused on the trunk and nondominant shoulder prevent a full understanding of U/L adaptations

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