Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement

Finley, Margaret; McQuade, Kevin J.; Rodgers, Mary M.

doi:10.1016/j.clinbiomech.2004.06.011

Cited by 89 publications

(91 citation statements)

References 28 publications

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“…Finley et al [8] also examined relative EMG activity during SPTs among long-term manual wheelchair users with and without shoulder impingement by using a normalization technique similar to the one Perry et al used [7]. These two groups of participants demonstrated comparable %MURs EMG across all muscles studied [8].…”

Section: Introductionmentioning

confidence: 99%

Does upper-limb muscular demand differ between preferred and nonpreferred sitting pivot transfer directions in individuals with a spinal cord injury?

Gagnon¹,

Koontz²,

Brindle³

et al. 2009

JRRD

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Abstract-This study's main objective was to determine if upper-limb (UL) muscular demand was reduced when individuals with a spinal cord injury (SCI) performed a sitting pivot transfer (SPT) in the preferred direction compared with that in a nonpreferred direction. Fourteen individuals (mean +/-standard deviation age 47.0 +/-8.3 yr, height 1.80 +/-0.08 m, and weight 75.3 +/-11.3 kg) with SCI levels ranging from the sixth cervical to first sacral vertebra levels volunteered to participate in this study during the 2008 National Disabled Veterans Winter Sports Clinic. Surface electromyography (EMG) was used to record activity of the biceps, triceps, deltoid, pectoralis major, trapezius, and latissimus dorsi bilaterally during SPTs. These transfers were performed in each of the preferred and nonpreferred directions from the individuals' wheelchairs to a padded tub bench of even height. To quantify electromyographic muscular utilization ratio (MUR EMG ), we normalized EMG data recorded during the transfer tasks to values obtained during static maximum voluntary contraction and then multiplied this ratio by 100 to obtain a percentage MUR EMG (%MUR EMG ). The overall peak %MUR EMG and the area under the %MUR EMG curve were selected as primary outcome measures. Similar peak %MUR EMGs were found between the preferred and nonpreferred transfer directions for all muscles from which data were recorded (p = 0.053 to 0.961). The peak %MUR EMGs were also found to be similar between the leading and trailing ULs during the transfers in all muscles from which data were recorded (p = 0.125 to 0.838), except for the anterior deltoid, which was found to be solicited the most in the trailing UL (p = 0.008). Comparable areas under the %MUR EMG curves were calculated between the preferred and nonpreferred transfer directions for all muscles (p = 0.289 to 0.678) and between the leading and trailing ULs (p = 0.104 to 0.946). These results indicate that direction preference expressed by individuals with SCI when transferring between seats of even height is not explained by relative muscular demand differences.Key words: activities of daily living, elbow, electromyography, paraplegia, rehabilitation, shoulder, spinal cord injury, task analysis, task performance, tetraplegia, upper limb.Abbreviations: ANOVA = analysis of variance; C = cervical; EMG = electromyography, electromyographic; EMG max = maximum EMG value, EMG transfer = EMG data collected during transfers; HERL = Human Engineering Research Laboratories; MUR EMG = EMG muscular utilization ratio; %MUR EMG = percentage MUR EMG ; MVC = maximal voluntary contraction; SCI = spinal cord injury; SD = standard deviation; sEMG = surface EMG; SPT = sitting pivot transfer; UL = upper limb; VA = Department of Veterans Affairs; WUSPI = Wheelchair User's Shoulder Pain Index.

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Section: Introductionmentioning

confidence: 99%

Does upper-limb muscular demand differ between preferred and nonpreferred sitting pivot transfer directions in individuals with a spinal cord injury?

Gagnon¹,

Koontz²,

Brindle³

et al. 2009

JRRD

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“…The SPT terminates when the buttocks land beside the leading hand on the target surface and sitting balance has been secured. On average, individuals with SCI perform 14 to 18 of these transfers a day [14][15]. Typical SPT examples include transferring from a wheelchair to a regular bed, a tub/shower bench, a toilet seat, a treatment table, or a car seat, and vice versa.…”

Section: Introductionmentioning

confidence: 99%

Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury

Gagnon

Nadeau²,

Noreau³

et al. 2008

JRRD

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Abstract-This study compared shoulder and elbow joint forces and moments between weight-relief lifts (WRLs) and sitting pivot transfers (SPTs) among manual wheelchair users with spinal cord injury (SCI) (N = 13) during biomechanical laboratory assessment. Minimum and maximum values were reported for each triaxial component of the joint force at the dominant shoulder and elbow during SPTs (leading and trailing roles) and WRLs. Peak shoulder flexor and adductor moments, along with elbow flexor and extensor moments, observed during the same period were also analyzed. The SPTs predominantly exposed (p < 0.001) the shoulder joints to substantial posteriorly directed forces (leading = -2.6 N/kg; trailing = -3.1 N/kg) compared with WRLs (-2.2 N/kg), whereas superiorly directed forces (2.9 N/kg) were principally sustained (p < 0.001) during WRLs compared with SPTs (leading = 1.5 N/kg; trailing = 1.5 N/kg). High superiorly directed forces (3.6 to 3.9 N/kg) were observed at the elbow, which were comparable (p = 0.33) between the two tasks. The peak shoulder flexor (leading = 1.36 N·m/kg; trailing = 1.45 N·m/kg) and adductor moments (leading only = -0.46 N·m/kg), along with the peak elbow flexor moments (leading = 0.24 N·m/kg; trailing = 0.15 N·m/kg), were significantly more elevated (p < 0.021) during SPTs than during WRLs. Peak shoulder adductor (-0.46 vs -0.24 N·m/kg) and elbow flexor moments were also more elevated (p = 0.03) at the leading upper limb compared with the trailing one. The peak elbow extensor moments did not differ (p = 0.167) between the two tasks (-0.17 to -0.25 N·m/kg). SPTs exposed the shoulder and elbow joints to greater mechanical loads than WRLs among individuals with SCI.

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“…This skill involves leaning the trunk forward to generate enough momentum to lift and rotate the buttocks up and over to the target surface [42]. Multiple studies have shown that using this skill may reduce shoulder forces and recruit larger muscle groups around the shoulders [3,43]. More recently, this skill was also found to be more dynamically stable and resilient to external disturbances compared with transferring with the trunk in a more upright posture [44].…”

Section: Transfer Skill Deficitsmentioning

confidence: 95%

“…A full-time wheelchair user usually performs 15 to 20 transfers each day [3]. Performing transfers is essential for completing tasks of daily living (e.g., bathing, toileting, and driving) and for enabling participation in a wide variety of public settings (e.g., restaurants, parks, pools, medical facilities) and recreational activities (e.g., handcycling, skiing, rugby).…”

Section: Introductionmentioning

confidence: 99%

Transfer component skill deficit rates among Veterans who use wheelchairs

et al. 2016

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Abstract-The purpose of this study was to quantify the deficit rates for transfer component skills in a Veteran cohort and explore the relationship between deficit rates and subject characteristics. Seventy-four men and 18 women performed up to four transfers independently from their wheelchair to a mat table while a therapist evaluated their transfer techniques using the Transfer Assessment Instrument. The highest deficit rates concerned the improper use of handgrips (63%). Other common problems included not setting the wheelchair up at the proper angle (50%) and not removing the armrest (58%). Veterans over 60 yr old and Veterans with moderate shoulder pain were more likely to set up their wheelchairs inappropriately than younger Veterans (p = 0.003) and Veterans with mild shoulder pain (p = 0.004). Women were less likely to remove their armrests than men (p = 0.03). Subjects with disabilities other than spinal cord injury were less inclined to set themselves up for a safe and easy transfer than the subjects with spinal cord injury (p  0.001). The results provide insight into the disparities present in transfer skills among Veterans and will inform the development of future transfer training programs both within and outside of the Department of Veterans Affairs.

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Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement

Cited by 89 publications

References 28 publications

Does upper-limb muscular demand differ between preferred and nonpreferred sitting pivot transfer directions in individuals with a spinal cord injury?

Does upper-limb muscular demand differ between preferred and nonpreferred sitting pivot transfer directions in individuals with a spinal cord injury?

Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury

Transfer component skill deficit rates among Veterans who use wheelchairs

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