title: Shoulder demands in manual wheelchair users across a spectrum of activities.
abstract: OBJECTIVE
  Investigate shoulder joint kinetics over a range of daily activity and mobility tasks associated with manual wheelchair propulsion to characterize demands placed on the shoulder during the daily activity of manual wheelchair users.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Twelve individuals who were experienced manual wheelchair users.
  
  
  METHODS
  Upper extremity kinematics and handrim wheelchair kinetics were measured over level propulsion, ramp propulsion, start and stop over level terrain, and a weight relief maneuver. Shoulder intersegmental forces and moments were calculated from inverse dynamics for all conditions.
  
  
  RESULTS
  Weight relief resulted in significantly higher forces and ramp propulsion resulted in significantly higher moments than the other conditions. Surprisingly, the start condition resulted in large intersegmental moments about the shoulder equivalent with that of the ramp propulsion, while the demand imparted by the stop condition was shown to be equivalent to level propulsion across all forces and moments.
  
  
  CONCLUSIONS
  This study provides characterization of daily living and mobility activities associated with manual wheelchair propulsion not previously reported and identifies activities that result in higher shoulder kinetics when compared to standard level propulsion.
authors.affiliation: Mayo Clinic College of Medicine, Department of Orthopedic Research, Mayo Clinic, Guggenheim Building 1-28, Rochester, MN 55905, USA.
authors.forename: Melissa M B
authors.initials: MM
authors.lastname: Morrow
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Hurd
authors.forename: Kenton R
authors.initials: KR
authors.lastname: Kaufman
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D005082:Physical Exertion; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D019415:Torque; D014910:Wheelchairs