title: Upper limb kinetic analysis of three sitting pivot wheelchair transfer techniques.
abstract: BACKGROUND
  The objective of this study was to investigate differences in shoulder, elbow and hand kinetics while performing three different SPTs that varied in terms of hand and trunk positioning.
  
  
  METHODS
  Fourteen unimpaired individuals (8 male and 6 female) performed three variations of sitting pivot transfers in a random order from a wheelchair to a level tub bench. Two transfers involved a forward flexed trunk (head-hips technique) and the third with the trunk remaining upright. The two transfers involving a head hips technique were performed with two different leading hand initial positions. Motion analysis equipment recorded upper body movements and force sensors recorded hand reaction forces. Shoulder and elbow joint and hand kinetics were computed for the lift phase of the transfer.
  
  
  RESULTS
  Transferring using either of the head hips techniques compared to the trunk upright style of transferring resulted in reduced superior forces at the shoulder (P<0.002), elbow (P<0.004) and hand (P<0.013). There was a significant increase in the medial forces in the leading elbow (P=0.049) for both head hip transfers and the trailing hand for the head hip technique with the arm further away from the body (P<0.028). The head hip techniques resulted in higher shoulder external rotation, flexion and extension moments compared to the trunk upright technique (P<0.021).
  
  
  CONCLUSIONS
  Varying the hand placement and trunk positioning during transfers changes the load distribution across all upper limb joints. The results of this study may be useful for determining a technique that helps preserve upper limb function overtime.
authors.affiliation: Human Engineering Research Laboratories, Department of Veteran Affairs, Pittsburgh, PA, USA. akoontz@pitt.edu
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
authors.forename: Padmaja
authors.initials: P
authors.lastname: Kankipati
authors.forename: Yen-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001696:Biomechanical Phenomena; D004550:Elbow / Q000033:anatomy & histology; D004551:Elbow Joint / Q000033:anatomy & histology; D004867:Equipment Design; D005260:Female; D006225:Hand / Q000033:anatomy & histology; D006615:Hip / Q000033:anatomy & histology; D006801:Humans; D007700:Kinetics; D008297:Male; D009038:Motion; D011187:Posture; D012785:Shoulder Joint / Q000033:anatomy & histology; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D034941:Upper Extremity / Q000033:anatomy & histology*; D014910:Wheelchairs