title: Evaluation of pediatric manual wheelchair mobility using advanced biomechanical methods.
abstract: There is minimal research of upper extremity joint dynamics during pediatric wheelchair mobility despite the large number of children using manual wheelchairs. Special concern arises with the pediatric population, particularly in regard to the longer duration of wheelchair use, joint integrity, participation and community integration, and transitional care into adulthood. This study seeks to provide evaluation methods for characterizing the biomechanics of wheelchair use by children with spinal cord injury (SCI). Twelve subjects with SCI underwent motion analysis while they propelled their wheelchair at a self-selected speed and propulsion pattern. Upper extremity joint kinematics, forces, and moments were computed using inverse dynamics methods with our custom model. The glenohumeral joint displayed the largest average range of motion (ROM) at 47.1° in the sagittal plane and the largest average superiorly and anteriorly directed joint forces of 6.1% BW and 6.5% BW, respectively. The largest joint moments were 1.4% body weight times height (BW × H) of elbow flexion and 1.2% BW × H of glenohumeral joint extension. Pediatric manual wheelchair users demonstrating these high joint demands may be at risk for pain and upper limb injuries. These evaluation methods may be a useful tool for clinicians and therapists for pediatric wheelchair prescription and training.
authors: Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA ; Rehabilitation Research Design and Disability (R 2 D 2 ) Center, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA ; Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA.
authors: Brooke A
authors: BA
authors: Slavens
authors: Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA.
authors: Alyssa J
authors: AJ
authors: Schnorenberg
authors: Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA.
authors: Christine M
authors: CM
authors: Aurit
authors: Shriners Hospitals for Children-Chicago, Chicago, IL 60707, USA.
authors: Adam
authors: A
authors: Graf
authors: Shriners Hospitals for Children-Chicago, Chicago, IL 60707, USA ; Physical Therapy Program, College of Health Sciences, Midwestern University, Downers Grove, IL 60515, USA.
authors: Joseph J
authors: JJ
authors: Krzak
authors: Shriners Hospitals for Children-Chicago, Chicago, IL 60707, USA.
authors: Kathryn
authors: K
authors: Reiners
authors: Shriners Hospitals for Children-Chicago, Chicago, IL 60707, USA.
authors: Lawrence C
authors: LC
authors: Vogel
authors: Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University and Medical College of Wisconsin, Milwaukee, WI 53233, USA ; Shriners Hospitals for Children-Chicago, Chicago, IL 60707, USA.
authors: Gerald F
authors: GF
authors: Harris
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D002648:Child; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology; D007700:Kinetics; D008297:Male; D009068:Movement; D013997:Time Factors; D014910:Wheelchairs; D055815:Young Adult