title: Relation between median and ulnar nerve function and wrist kinematics during wheelchair propulsion.
abstract: OBJECTIVE
  To investigate the relation between median and ulnar nerve health and wrist kinematics in wheelchair users.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Biomechanics laboratory and electrodiagnostic laboratory at a Veterans Health Administration medical center and a university hospital, respectively.
  
  
  METHODS
  Thirty-five people with spinal cord injury who use manual wheelchairs.
  
  
  METHODS
  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.
  
  
  METHODS
  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.affiliation: 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
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Impink
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008475:Median Nerve / Q000502:physiology*; D008875:Middle Aged; D009431:Neural Conduction; D016059:Range of Motion, Articular; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014459:Ulnar Nerve / Q000502:physiology*; D014910:Wheelchairs; D014955:Wrist Joint / Q000502:physiology*