The Influence of Age at Pediatric-Onset Spinal Cord Injury and Years of Wheelchair Use on Shoulder Complex Joint Dynamics During Manual Wheelchair Propulsion.
The Influence of Age at Pediatric-Onset Spinal Cord Injury and Years of Wheelchair Use on Shoulder Complex Joint Dynamics During Manual Wheelchair Propulsion.
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DOI：
10.1016/j.arrct.2022.100235
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发表时间：
2022-12
影响因子：
--
通讯作者：
中科院分区：
文献类型：
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目的：评估儿童脊髓损伤(SCI)的发病年龄和手动轮椅使用年限与肩部动力学的关系。在手动轮椅推进过程中，得到了上肢运动学和手环动力学。逆向动力学模型计算了肩锁关节、胸锁关节和肩锁关节的三维动力学。线性混合效应模型评估了损伤开始时的年龄和轮椅使用年限与肩部动力学的关系。儿童医院内的运动实验室。17名手动轮椅使用者(N=17；6女，11男；平均年龄：17.2岁，平均发病年龄：11.5岁)患有儿童脊髓损伤(级别：C4-T11)和国际脊髓损伤分级标准：A(11)、B(3)、C(2)和N/A(2)。不适用。肩锁、胸锁和肩周骨的角度和活动范围，以及肩周力和力矩。我们观察到，随着SCI发病年龄的增加，肩锁关节最大上旋角度降低(？[95%可信区间{CI}]=3.02[0.15，5.89]，P=.039)，肩锁关节向下/向上旋转范围增加(？[95%CI]=0.44[0.08，0.80]，P=0.016)。我们发现发病年龄与肩锁关节最大外展年限(？[95%CI]=0.16[0.03，0.29]，P=.017)、肩锁关节向下/向上旋转范围(？？[95%CI]=-0.05[-0.09，-0.01]，P=.008)、最小肩锁关节向上旋转(？[95%CI]=-0.34[-0.64，-0.04]，P=.026)之间存在交互作用。随着使用年限的增加，肩关节内旋转力矩(95%CI]=-0.09[-0.17，-0.009]，P=0.029)逐渐减小。受伤年龄和轮椅使用年限与轮椅推进过程中肩部复杂的生物力学有关。这些结果值得注意，因为脊髓损伤的发病年龄和轮椅使用年限都被认为是肩痛发生率的重要因素。这些结果表明，研究寿命过程中的生物力学变化是至关重要的。
To assess the association of age at pediatric-onset spinal cord injury (SCI) and years of manual wheelchair use with shoulder dynamics. Upper extremity kinematics and hand-rim kinetics were obtained during manual wheelchair propulsion. An inverse dynamics model computed three-dimensional acromioclavicular, sternoclavicular, and glenohumeral joint dynamics. Linear mixed effects models evaluated the association of age at injury onset and years of wheelchair use with shoulder dynamics. Motion laboratory within a children's hospital. Seventeen manual wheelchair users (N=17; 6 female, 11 male; mean age: 17.2 years, mean age at SCI onset: 11.5 years) with pediatric-onset SCI (levels: C4-T11) and International Standards for Neurological Classification of SCI grades: A (11), B (3), C (2), and N/A (2). Not applicable. Acromioclavicular, sternoclavicular, and glenohumeral angles and ranges of motion, and glenohumeral forces and moments. We observed a decrease in maximum acromioclavicular upward rotation (ß [95% confidence interval {CI}]=3.02 [0.15,5.89], P=.039) and an increase in acromioclavicular downward/upward rotation range of motion (ß [95% CI]=0.44 [0.08,0.80], P=.016) with increasing age at SCI onset. We found interactions between age at onset and years of use for maximum glenohumeral abduction (ß [95% CI]=0.16 [0.03,0.29], P=.017), acromioclavicular downward/upward rotation range of motion (ß [95% CI]=-0.05 [-0.09,-0.01], P=.008), minimum acromioclavicular upward rotation (ß [95% CI]=-0.34 [-0.64,-0.04], P=.026). A decrease in glenohumeral internal rotation moment (ß [95% CI]=-0.09 [-0.17,-0.009], P=.029) with increasing years of use was found. Age at injury and the years of wheelchair use are associated with shoulder complex biomechanics during wheelchair propulsion. These results are noteworthy, as both age at SCI onset and years of wheelchair use are considered important factors in the incidence of shoulder pain. These results suggest that investigations of biomechanical changes over the lifespan are critical.
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DOI：
10.5435/jaaos-d-18-00830
发表时间：
2020-07-01
影响因子：
3.2
作者：
Chalmers, Peter N.;Beck, Lindsay;Tashjian, Robert Z.
通讯作者：
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影响因子：
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DOI：
10.2519/jospt.2002.32.6.248
发表时间：
2002-06-01
影响因子：
6.1
作者：
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通讯作者：
Cook, TA
影响因子：
5.3
作者：
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