The relationship between the hand pattern used during fast wheelchair propulsion and shoulder pain development.
The relationship between the hand pattern used during fast wheelchair propulsion and shoulder pain development.
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DOI：
10.1016/j.jbiomech.2020.110202
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发表时间：
2021-02-12
影响因子：
2.4
通讯作者：
Neptune RR
中科院分区：
文献类型：
--
作者：
Walford SL;Rankin JW;Mulroy SJ;Neptune RR
高达84%的脊髓损伤的手动轮椅使用者（mwcu）经历肩部疼痛，这与该人群的肩部内收肌无力有关。模型研究表明，在推进过程中，肩部内收肌无力导致三角肌和肩袖肌的代偿，这可能导致推进力学的改变。然而，恢复阶段手部模式在疼痛发展中的作用尚不清楚，因为每种手部模式都与独特的力学和不同水平的肌肉需求有关。先前的研究发现，在自己选择的速度下，手部模式和肩部疼痛之间没有关联。然而，快速推进可能会加剧肩部肌肉无力引起的力学不良，这可能会暴露出那些有疼痛发展风险的人。本研究评估了在轮椅快速推进过程中使用的手部模式是否与肩痛相关。我们还评估了肩内收肌强度是否与手型相关。在三个时间点（基线、18个月、36个月）分析了两个MWCU子集的快速推进数据。所有参与者在基线时均无疼痛。亚组1比较了没有疼痛的个体和出现肩痛的个体。亚组2比较了慢性疼痛患者和疼痛随时间消退的患者。在两个子集中，两组之间使用的手部图案没有差异。然而，在子集1中，更多的过边缘模式与较低的内收肌强度相关。这些结果表明，尽管在快速推进过程中使用的手型与肩部疼痛无关，但更多的手型可能表明肩部内收肌较弱。
Up to 84% of manual wheelchair users (MWCUs) with spinal cord injury experience shoulder pain, which is correlated with shoulder adductor weakness in this population. Modeling studies have shown weak shoulder adductors lead to compensations from the deltoid and rotator cuff muscles during propulsion, which may lead to altered propulsion mechanics. However, the role recovery phase hand pattern has in pain development is unclear, as each hand pattern is associated with unique mechanics and different levels of muscle demand. Previous research found no correlation between hand pattern and shoulder pain at self-selected speeds. However, fast propulsion may exacerbate poor mechanics caused by shoulder muscle weakness, which may reveal those at risk for pain development. The present study evaluated whether the hand pattern used during fast wheelchair propulsion is correlated with shoulder pain. We also assessed whether shoulder adductor strength was correlated with hand pattern. Fast propulsion data from two subsets of MWCU were analyzed at three time points (baseline, 18 months, 36 months). All participants were pain-free at baseline. Subset 1 compared individuals who remained pain-free to those who developed shoulder pain. Subset 2 compared individuals with chronic pain at follow-up to those whose pain resolved over time. The hand pattern used was not different between groups in either subset. However, more over-rim patterns were correlated with lower adductor strength in Subset 1. These results suggest that although the hand pattern used during fast propulsion is not correlated with shoulder pain, more over-rim hand patterns may indicate weaker shoulder adductors.
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DOI：
10.1016/j.apmr.2007.09.052
发表时间：
2008-04-01
影响因子：
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