An exercise trial targeting posterior shoulder strength in manual wheelchair users: pilot results and lessons learned.
OBJECTIVE
Because wheelchair users are unable to use standard fitness equipment such as treadmills and bikes, we developed an upper body rowing ergometer (UBRE) that can be retrofitted onto a standard stationary cycle and used to perform a rowing exercise. We validated a graded exercise testing protocol utilizing the UBRE and completed a 12-week pilot intervention to compare the training effects of the UBRE to a standard arm cycle ergometer (ACE) in manual wheelchair users.


METHODS
Repeat graded exercise tests were compared on the two pieces of equipment. Twenty-seven manual wheelchair users participated in the intervention. Outcomes included pre- versus post-test change in shoulder pain, strength and cardiorespiratory fitness measures.


RESULTS
Testing results obtained with the UBRE were comparable to those on the ACE. In the exercise intervention, most outcome measures did not change significantly, but individuals assigned to the UBRE were able to increase their peak exercise test power by 31 W and duration by 3.6 min.


CONCLUSIONS
There is biomechanical reason to believe that rowing exercises may improve shoulder muscle balance in this population, which could reduce the risk of impingement. This may be of benefit to manual wheelchair users, who are at high risk for shoulder injury. Implications for Rehabilitation Regular exercise improves cardiorespiratory fitness and did not exacerbate shoulder pain in this group of manual wheelchair users. Exercises that target posterior shoulder muscle groups, such as rowing, may improve muscle balance and reduce the risk of shoulder impingement. Participation in exercise is hindered in this population by a high rate of secondary health conditions and difficulty accessing facilities and equipment.
Department of Biomedical Engineering, Worcester Polytechnic Institute , Worcester, MA , USA .
Karen L
KL
Troy
Thayne A
TA
Munce
Jessica A
JA
Longworth
D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology*; D010101:Oxygen Consumption; D010809:Physical Fitness / Q000502:physiology*; D010865:Pilot Projects; D012782:Shoulder / Q000502:physiology*; D020069:Shoulder Pain / Q000503:physiopathology; D014910:Wheelchairs
Arm cycle ergometer; VO2; cardiorespiratory; cardiovascular; oxygen uptake; pain; rowing