title: Effect of power-assisted hand-rim wheelchair propulsion on shoulder load in experienced wheelchair users: A pilot study with an instrumented wheelchair.
abstract: This study aims to compare hand-rim and power-assisted hand-rim propulsion on potential risk factors for shoulder overuse injuries: intensity and repetition of shoulder loading and force generation in the extremes of shoulder motion. Eleven experienced hand-rim wheelchair users propelled an instrumented wheelchair on a treadmill while upper-extremity kinematic, kinetic and surface electromyographical data was collected during propulsion with and without power-assist. As a result during power-assisted propulsion the peak resultant force exerted at the hand-rim decreased and was performed with significantly less abduction and internal rotation at the shoulder. At shoulder level the anterior directed force and internal rotation and flexion moments decreased significantly. In addition, posterior and the minimal inferior directed forces and the external rotation moment significantly increased. The stroke angle decreased significantly, as did maximum shoulder flexion, extension, abduction and internal rotation. Stroke-frequency significantly increased. Muscle activation in the anterior deltoid and pectoralis major also decreased significantly. In conclusion, compared to hand-rim propulsion power-assisted propulsion seems effective in reducing potential risk factors of overuse injuries with the highest gain on decreased range of motion of the shoulder joint, lower peak propulsion force on the rim and reduced muscle activity.
authors: Roessingh Research and Development, Enschede, The Netherlands; Faculty of Engineering Technology, Laboratory of Biomechanical Engineering, University of Twente, Enschede, The Netherlands. Electronic address: mariekekloosterman83@gmail.com.
authors: Marieke G M
authors: MG
authors: Kloosterman
authors: Roessingh Research and Development, Enschede, The Netherlands; Faculty of Electrical Engineering, Mathematics and Computer Science, Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands. Electronic address: j.buurke@rrd.nl.
authors: Jaap H
authors: JH
authors: Buurke
authors: Roessingh Research and Development, Enschede, The Netherlands. Electronic address: wdv.work@gmail.com.
authors: Wiebe
authors: W
authors: de Vries
authors: University of Groningen, Groningen, University Medical Center Groningen, Center for Human Movement Sciences & Center for Rehabilitation, The Netherlands. Electronic address: l.h.v.van.der.woude@med.umcg.nl.
authors: Lucas H V
authors: LH
authors: Van der Woude
authors: Roessingh Research and Development, Enschede, The Netherlands; Faculty of Engineering Technology, Laboratory of Biomechanical Engineering, University of Twente, Enschede, The Netherlands; Department Rehabilitation, Medical Spectrum Twente, Enschede, The Netherlands. Electronic address: j.s.rietman@rrd.nl.
authors: Johan S
authors: JS
authors: Rietman
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D012090:Cumulative Trauma Disorders / Q000517:prevention & control; D055615:Electrical Equipment and Supplies; D004576:Electromyography; D006225:Hand; D006801:Humans; D007700:Kinetics; D018482:Muscle, Skeletal / Q000502:physiology; D010865:Pilot Projects; D012782:Shoulder / Q000502:physiology*; D014910:Wheelchairs
keywords: Assistive devices; Electromyography; Kinematics; Kinetics; Power-assisted wheelchair; Shoulder; Upper extremity; Wheelchair propulsion