title: Power-assisted wheels ease energy costs and perceptual responses to wheelchair propulsion in persons with shoulder pain and spinal cord injury.
abstract: OBJECTIVE
  Test effects of pushrim-activated power-assisted wheelchairs (PAPAWs) on the energetics and perceptual responses to steady-state and intensity-graded wheelchair propulsion in persons with paraplegia and tetraplegia having chronic shoulder pain.
  
  
  METHODS
  Test, retest with a control condition.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Subjects (N=18) aged 19 to 70 years with chronic, motor-complete paraplegia and tetraplegia having confirmed shoulder pain.
  
  
  METHODS
  Study participants underwent testing on 4 randomized nonconsecutive days during either 6 minutes of steady-state or 12 minutes of intensity-graded wheelchair propulsion on stationary rollers. Participants used their own manual wheelchair and either their customary wheels or power-assist wheels attached with an axle bracket.
  
  
  METHODS
  Oxygen consumption (V(.)O2, L/min), distance (m), energy cost (L/m), and ratings of perceived exertion (RPE; Borg Categorical 6-20 Scale) were measured during propulsion.
  
  
  RESULTS
  Significant main effects of testing were observed for V(.)O2, heart rate, and RPE in both subject groups. Distances propelled were significantly increased in both groups across both tests and in each of their 2-minute exercise stages.
  
  
  CONCLUSIONS
  Use of PAPAWs by persons with paraplegia and tetraplegia having shoulder pain significantly lowers energy cost responses and perceived exertion compared with manual wheelchair propulsion while significantly increasing the distanced propelled.
authors.affiliation: Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA. msnash@miami.edu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Nash
authors.forename: Daan
authors.initials: D
authors.lastname: Koppens
authors.forename: Mirjam
authors.initials: M
authors.lastname: van Haaren
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Sherman
authors.forename: James P
authors.initials: JP
authors.lastname: Lippiatt
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D011211:Electric Power Supplies; D004734:Energy Metabolism; D004867:Equipment Design; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010264:Paraplegia / Q000150:complications / Q000534:rehabilitation; D017060:Patient Satisfaction; D005082:Physical Exertion; D011782:Quadriplegia / Q000150:complications / Q000534:rehabilitation; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control*; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D014910:Wheelchairs / Q000009:adverse effects