Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota.
Top Spinal Cord Inj Rehabil. 2021 Fall;27(3):12-25. doi: 10.46292/sci20-00059. Epub 2021 Aug 13.
Individuals with spinal cord injury (SCI) who use manual wheelchairs (MWCs) have a higher rate of rotator cuff pathology progression than able-bodied individuals.
This study aimed to test the ability of risk and recovery metrics of arm use to differentiate between (1) MWC users with SCI and matched able-bodied participants (cross-sectional matched-sample study) and (2) MWC users with rotator cuff pathology progression over 1 year from those without pathology progression (longitudinal study).
Thirty-four MWC users and 34 age- and sex-matched able-bodied individuals were recruited. Upper arm risk (humeral elevation >60°) and recovery (static ≥5 seconds and humeral elevation <40°) metrics were calculated from wireless inertial measurement units (IMUs) worn on the upper arms and torso in the free-living environment. Two separate magnetic resonance imaging studies were completed and assessed for a subset of 16 MWC users approximately 1 year apart.
The frequency of risk events ( = .019), summated duration of recovery events ( = .025), and duration of each recovery event ( = .003) were higher for MWC users than able-bodied participants. The summated duration of risk events ( = .047), frequency of risk events ( = .027), and risk to recovery ratio ( = .02) were higher and the summated duration of recovery events ( = .036) and frequency of recovery events ( = .047) were lower for MWC users with rotator cuff pathology progression ( = 5) compared to those without progression ( = 11).
IMU-derived metrics quantifying arm use at postures >60° and risk to recovery ratios may provide insights of potential risk factors for rotator cuff pathology progression.
使用手动轮椅（MWC）的脊髓损伤（SCI）患者比健全人更容易出现肩袖病变进展。
本研究旨在测试手臂使用的风险和恢复指标，以区分（1）MWC 使用者 SCI 与匹配的健全参与者（横断面匹配样本研究）和（2）MWC 使用者肩袖病变进展超过 1 年与无病变进展（纵向研究）。
招募了 34 名 MWC 用户和 34 名年龄和性别匹配的健全人。在上臂和躯干上佩戴无线惯性测量单元（IMU），在自由生活环境中计算出上肢风险（肱骨抬高>60°）和恢复（静态≥5 秒和肱骨抬高<40°）指标。对 16 名 MWC 用户中的一小部分进行了两次独立的磁共振成像研究，大约相隔 1 年。
MWC 用户的风险事件频率（ =.019）、恢复事件总持续时间（ =.025）和每次恢复事件持续时间（ =.003）高于健全参与者。MWC 用户的风险事件总持续时间（ =.047）、风险事件频率（ =.027）和风险恢复比（ =.02）较高，而肩袖病变进展（ = 5）的 MWC 用户的恢复事件总持续时间（ =.036）和恢复事件频率（ =.047）较低。与无进展者（ = 11）相比。
IMU 衍生的指标量化了>60°姿势和风险恢复比的手臂使用情况，可能为肩袖病变进展的潜在危险因素提供了见解。
