Shoulder Biomechanics During the Push Phase of Wheelchair Propulsion: A Multisite Study of Persons With Paraplegia

Abstract Collinger JL, Boninger ML, Koontz AM, Price R, Sisto SA, Tolerico ML, Cooper RA. Shoulder biomechanics during the push phase of wheelchair propulsion: a multisite study of persons with paraplegia. Objectives To present a descriptive analysis and comparison of shoulder kinetics and kinematics during wheelchair propulsion at multiple speeds (self-selected and steady-state target speeds) for a large group of manual wheelchair users with paraplegia while also investigating the effect of pain and subject demographics on propulsion. Design Case series. Setting Three biomechanics laboratories at research institutions. Participants Volunteer sample of 61 persons with paraplegia who use a manual wheelchair for mobility. Intervention Subjects propelled their own wheelchairs on a dynamometer at 3 speeds (self-selected, 0.9m/s, 1.8m/s) while kinetic and kinematic data were recorded. Main Outcome Measures Differences in demographics between sites, correlations between subject characteristics, comparison of demographics and biomechanics between persons with and without pain, linear regression using subject characteristics to predict shoulder biomechanics, comparison of biomechanics between speed conditions. Results Significant increases in shoulder joint loading with increased propulsion velocity were observed. Resultant force increased from 54.4±13.5N during the 0.9m/s trial to 75.7±20.7N at 1.8m/s ( P