Document Detail

Shoulder muscular demand during lever-activated vs pushrim wheelchair propulsion in persons with spinal cord injury.
MedLine Citation:
PMID:  19086715     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/OBJECTIVE: The high demand on the upper limbs during manual wheelchair (WC) use contributes to a high prevalence of shoulder pathology in people with spinal cord injury (SCI). Lever-activated (LEVER) WCs have been presented as a less demanding alternative mode of manual WC propulsion. The objective of this study was to evaluate the shoulder muscle electromyographic activity and propulsion characteristics in manual WC users with SCI propelling a standard pushrim (ST) and LEVER WC design. METHODS: Twenty men with complete injuries (ASIA A or B) and tetraplegia (C6, n = 5; C7, n = 7) or paraplegia (n = 8) secondary to SCI propelled ST and LEVER WCs at 3 propulsion conditions on a stationary ergometer: self-selected free, self-selected fast, and simulated graded resistance. Average velocity, cycle distance, and cadence; median and peak electromyographic intensity; and duration of electromyography of anterior deltoid, pectoralis major, supraspinatus, and infraspinatus muscles were compared between LEVER and ST WC propulsion. RESULTS: Significant decreases in pectoralis major and supraspinatus activity were recorded during LEVER compared with ST WC propulsion. However, anterior deltoid and infraspinatus intensities tended to increase during LEVER WC propulsion. Participants with tetraplegia had similar or greater anterior deltoid, pectoralis major, and infraspinatus activity for both ST and LEVER WC propulsion compared with the men with paraplegia. CONCLUSIONS: Use of the LEVER WC reduced and shifted the shoulder muscular demands in individuals with paraplegia and tetraplegia. Further studies are needed to determine the impact of LEVER WC propulsion on long-term shoulder function.
Philip Santos Requejo; Sharon E Lee; Sara J Mulroy; Lisa Lighthall Haubert; Ernest L Bontrager; JoAnne K Gronley; Jacquelin Perry
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The journal of spinal cord medicine     Volume:  31     ISSN:  1079-0268     ISO Abbreviation:  J Spinal Cord Med     Publication Date:  2008  
Date Detail:
Created Date:  2008-12-17     Completed Date:  2009-04-09     Revised Date:  2010-09-23    
Medline Journal Info:
Nlm Unique ID:  9504452     Medline TA:  J Spinal Cord Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  568-77     Citation Subset:  IM    
Department of Pathokinesiology, Rancho Los Amigos National Rehabilitation Center, Downey, CA 90242, USA.
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MeSH Terms
Electromyography / methods
Middle Aged
Muscle, Skeletal / physiopathology*
Paraplegia / physiopathology,  rehabilitation
Quadriplegia / physiopathology,  rehabilitation
Shoulder / physiopathology*
Spinal Cord Injuries / pathology*,  physiopathology*,  rehabilitation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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