Michael L Boninger1, Bradley G Impink, Rory A Cooper, Alicia M Koontz. 1. Department of Physical Medicine and Rehabilitation, Human Engineering Research Laboratories, School of Medicine, University of Pittsburgh and VA Pittsburgh Health Care System, 7180 Highland Drive, 151R-1, Pittsburgh, PA 15206, USA. Boninger@pitt.edu
Abstract
OBJECTIVE: To investigate the relation between median and ulnar nerve health and wrist kinematics in wheelchair users. DESIGN: Case series. SETTING: Biomechanics laboratory and electrodiagnostic laboratory at a Veterans Health Administration medical center and a university hospital, respectively. PARTICIPANTS: Thirty-five people with spinal cord injury who use manual wheelchairs. INTERVENTION: Subjects propelled their own wheelchair on a dynamometer at 0.9 and 1.8m/s. Bilateral biomechanic data were obtained by using force and moment sensing pushrims and a kinematic system. Bilateral median and ulnar nerve conduction studies were also completed. MAIN OUTCOME MEASURES: Wrist flexion, extension, radial and ulnar deviation peaks, and ranges of motion (ROMs) as related to median and ulnar motor and sensory amplitudes. A secondary analysis included peak pushrim forces and moments and stroke frequency. RESULTS: There was a significant, positive correlation between flexion and extension ROM and both ulnar motor amplitude (r=.383, P<.05) and median motor amplitude (r=.361, P<.05). CONCLUSIONS: Contrary to our hypothesis, subjects using a greater ROM showed better nerve function than subjects propelling with a smaller ROM. Subjects using a larger ROM used less force and fewer strokes to propel their wheelchairs at a given speed. It is possible that long, smooth strokes may benefit nerve health in manual wheelchair users.
OBJECTIVE: To investigate the relation between median and ulnar nerve health and wrist kinematics in wheelchair users. DESIGN: Case series. SETTING: Biomechanics laboratory and electrodiagnostic laboratory at a Veterans Health Administration medical center and a university hospital, respectively. PARTICIPANTS: Thirty-five people with spinal cord injury who use manual wheelchairs. INTERVENTION: Subjects propelled their own wheelchair on a dynamometer at 0.9 and 1.8m/s. Bilateral biomechanic data were obtained by using force and moment sensing pushrims and a kinematic system. Bilateral median and ulnar nerve conduction studies were also completed. MAIN OUTCOME MEASURES: Wrist flexion, extension, radial and ulnar deviation peaks, and ranges of motion (ROMs) as related to median and ulnar motor and sensory amplitudes. A secondary analysis included peak pushrim forces and moments and stroke frequency. RESULTS: There was a significant, positive correlation between flexion and extension ROM and both ulnar motor amplitude (r=.383, P<.05) and median motor amplitude (r=.361, P<.05). CONCLUSIONS: Contrary to our hypothesis, subjects using a greater ROM showed better nerve function than subjects propelling with a smaller ROM. Subjects using a larger ROM used less force and fewer strokes to propel their wheelchairs at a given speed. It is possible that long, smooth strokes may benefit nerve health in manual wheelchair users.
Authors: Fransiska M Bossuyt; Nathan S Hogaboom; Lynn A Worobey; Alicia M Koontz; Ursina Arnet; Michael L Boninger Journal: J Spinal Cord Med Date: 2019-03-18 Impact factor: 1.985
Authors: Philip Santos Requejo; Sharon E Lee; Sara J Mulroy; Lisa Lighthall Haubert; Ernest L Bontrager; JoAnne K Gronley; Jacquelin Perry Journal: J Spinal Cord Med Date: 2008 Impact factor: 1.985