Ian M Rice1, Chandrasekaran Jayaraman2, Elizabeth T Hsiao-Wecksler3, Jacob J Sosnoff4. 1. Departments of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL. 2. Industrial Enterprise Systems Engineering, University of Illinois at Urbana-Champaign, Urbana, IL. 3. Mechanical Sciences and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL. 4. Departments of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL. Electronic address: jsosnoff@illinois.edu.
Abstract
OBJECTIVE: To examine intra-individual variability of kinetic and temporal-spatial parameters of wheelchair propulsion as a function of shoulder pain in manual wheelchair users (MWUs). DESIGN: Cohort. SETTING: University research laboratory. PARTICIPANTS: Adults with physical disabilities (N=26) who use a manual wheelchair for mobility full time (>80% ambulation). INTERVENTIONS: Participants propelled their own wheelchairs with force-sensing wheels at a steady-state pace on a dynamometer at 3 speeds (self-selected, 0.7m/s, 1.1m/s) for 3 minutes. Temporal-spatial and kinetic data were recorded unilaterally at the hand rim. MAIN OUTCOME MEASURES: Shoulder pain was quantified with the Wheelchair Users Shoulder Pain Index. Intra-individual mean, SD, and coefficient of variation (CV=mean/SD) with kinetic and temporal-spatial metrics were determined at the handrim. RESULTS: There were no differences in mean kinetic and temporal-spatial metrics as a function of pain group (P values >.016). However, individuals with pain displayed less relative variability (CV) in peak resultant force and push time than pain-free individuals (P<.016). CONCLUSIONS: Shoulder pain had no influence on mean kinetic and temporal-spatial propulsion variables at the handrim; however, group differences were found in relative variability. These results suggest that intra-individual variability analysis is sensitive to pain. We propose that variability analysis may offer an approach for earlier identification of MWUs at risk for developing shoulder pain.
OBJECTIVE: To examine intra-individual variability of kinetic and temporal-spatial parameters of wheelchair propulsion as a function of shoulder pain in manual wheelchair users (MWUs). DESIGN: Cohort. SETTING: University research laboratory. PARTICIPANTS: Adults with physical disabilities (N=26) who use a manual wheelchair for mobility full time (>80% ambulation). INTERVENTIONS:Participants propelled their own wheelchairs with force-sensing wheels at a steady-state pace on a dynamometer at 3 speeds (self-selected, 0.7m/s, 1.1m/s) for 3 minutes. Temporal-spatial and kinetic data were recorded unilaterally at the hand rim. MAIN OUTCOME MEASURES: Shoulder pain was quantified with the Wheelchair Users Shoulder Pain Index. Intra-individual mean, SD, and coefficient of variation (CV=mean/SD) with kinetic and temporal-spatial metrics were determined at the handrim. RESULTS: There were no differences in mean kinetic and temporal-spatial metrics as a function of pain group (P values >.016). However, individuals with pain displayed less relative variability (CV) in peak resultant force and push time than pain-free individuals (P<.016). CONCLUSIONS: Shoulder pain had no influence on mean kinetic and temporal-spatial propulsion variables at the handrim; however, group differences were found in relative variability. These results suggest that intra-individual variability analysis is sensitive to pain. We propose that variability analysis may offer an approach for earlier identification of MWUs at risk for developing shoulder pain.
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