From the Centre for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (JB, RJKV, MTL, HH); The Healthcare Improvement Studies (THIS) Institute, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom (JWvdS); Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands (MT, FABW, LHVvdW); Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, United Kingdom (LHVvdW); Amsterdam Rehabilitation Research Centre | Reade, Amsterdam, the Netherlands (SdG); and Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands (SdG).
Am J Phys Med Rehabil. 2023 Oct 1;102(10):886-895. doi: 10.1097/PHM.0000000000002240. Epub 2023 Mar 14.
The aim of this study was to compare handrim wheelchair propulsion technique between individuals with spinal cord injury with and without shoulder pain.
A cross-sectional study including 38 experienced handrim wheelchair users with spinal cord injury was conducted. Participants were divided into the "shoulder pain" ( n = 15) and "no-shoulder pain" ( n = 23) groups using the Local Musculoskeletal Discomfort scale. Kinetic and spatiotemporal aspects of handrim wheelchair propulsion during submaximal exercise on a motor-driven treadmill were analyzed. Data were collected using a measurement wheel instrumented with three-dimensional force sensors.
After correction for confounders (time since injury and body height), linear regression analyses showed that the pain group had a 0.30-sec (95% confidence interval, -0.5 to -0.1) shorter cycle time, 0.22-sec (95% confidence interval, -0.4 to -0.1) shorter recovery time, 15.6 degrees (95% confidence interval, -27.4 to -3.8) smaller contact angle, and 8% (95% confidence interval, -15 to 0) lower variability in work per push compared with the no-pain group. Other parameters did not differ between groups.
This study indicates that individuals with spinal cord injury who experience shoulder pain propel their handrim wheelchair kinematically differently from individuals with spinal cord injury without shoulder pain. This difference in propulsion technique might be a pain-avoiding mechanism aimed at decreasing shoulder range of motion.
本研究旨在比较脊髓损伤伴或不伴肩痛患者的手推轮椅推进技术。
进行了一项横断面研究，纳入了 38 名有经验的手推轮椅使用者，他们均患有脊髓损伤。参与者根据局部肌肉骨骼不适量表分为“肩痛”（n=15）和“无肩痛”（n=23）组。在手驱动跑步机上进行亚最大运动时，分析手推轮椅推进的运动学和时空方面。使用装有三维力传感器的测量轮仪器收集数据。
在对混杂因素（受伤时间和身高）进行校正后，线性回归分析表明，疼痛组的周期时间缩短了 0.30 秒（95%置信区间，-0.5 至-0.1），恢复时间缩短了 0.22 秒（95%置信区间，-0.4 至-0.1），接触角减小了 15.6 度（95%置信区间，-27.4 至-3.8），每推一次的功的变异性降低了 8%（95%置信区间，-15 至 0）。其他参数在两组之间没有差异。
本研究表明，患有肩痛的脊髓损伤患者的手推轮椅推进技术与无肩痛的脊髓损伤患者不同。这种推进技术的差异可能是一种避免疼痛的机制，旨在减少肩部活动范围。
