title: Upper limb joint kinetics of three sitting pivot wheelchair transfer techniques in individuals with spinal cord injury.
abstract: METHODS
  Repeated measures design.
  
  
  OBJECTIVE
  This study compared the upper extremity (UE) joint kinetics between three transfer techniques.
  
  
  METHODS
  Research laboratory.
  
  
  METHODS
  Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head-hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers.
  
  
  RESULTS
  Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique.
  
  
  CONCLUSIONS
  Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement.
authors.forename: Padmaja
authors.initials: P
authors.lastname: Kankipati
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.forename: Dany
authors.initials: D
authors.lastname: Gagnon
authors.forename: Rory A
authors.initials: RA
authors.lastname: Cooper
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Koontz
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D050823:Hand Joints / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D012785:Shoulder Joint / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D014910:Wheelchairs
keywords: Activities of daily living; Biomechanics; Rehabilitation; Secondary impairments; Shoulder pain