Three-dimensional shoulder kinematics during a pressure relief technique and wheelchair transfer

Nawoczenski DA, Clobes SM, Gore SL, Neu JL, Olsen JE, Borstad JD, Ludewig PM. Three-dimensional shoulder kinematics during a pressure relief technique and wheelchair transfer. Arch Phys Med Rehabil 2003;84:1293–300. Objective: To assess 3-dimensional scapulothoracic and glenohumeral kinematics in able-bodied subjects during a weight-relief raise and while transferring to and from a wheelchair. Design: Repeated-measures analysis of variance. Setting: Research laboratory. Participants: Twenty-five able-bodied subjects without spinal cord injury or shoulder symptoms (20 men, 5 women; age range, 20–37y). Interventions: Completion of weight-relief raise and transfer tasks. Main Outcome Measures: An electromagnetic motion capture system tracked 3-dimensional position and orientation of the thorax, scapula, and humerus. Absolute angular values assessed included scapular downward and upward rotation, internal and external rotation, and posterior and anterior tipping all relative to the thorax, as well as humeral internal and external rotation relative to the scapula. Data were compared across 3 phases of the weight-relief raise and for transfer direction (leading arm, trailing arm). Results: Key findings included significantly increased anterior tipping and internal rotation of the scapula and decreased scapular upward rotation and external rotation of the humerus during the weight-relief raise. The leading arm showed significantly greater scapular anterior tipping and internal rotation and less scapular upward rotation and humeral external rotation than the trailing arm during the final phase of the transfer. Conclusions: Both the weight-relief raise and transfer result in scapular and humeral positions and directions of motion that may negatively impact the available subacromial space. This may present increased risk for injury or progression of shoulder pain in persons who must routinely perform these tasks.