WHEELCHAIR PROPULSION BIOMECHANICS AND ARM PAIN

上肢疼痛(UEP)是患有以下疾病的人的严重问题 依靠手动轮椅使用以获得移动性。肩周炎的患病率 手动轮椅使用者(MWU)合并脊髓损伤的疼痛 在30%到70%之间，以及单神经疾病，如腕管 综合症的患病率在40%到60%之间。因为上层 肢体对于脊髓损伤患者的几乎所有活动都是必不可少的， UEP可导致严重的继发性残疾。对……原因的研究 UEP一直是有限的，几乎没有研究关注过 干预或预防。在这项研究中，我们将检验这一假设 UEP和病理与特定的关节角度、力矩和 在手动轮椅推进过程中产生的力。我们的具体目标 主要内容有：1)确定区分不同生物力学因素 上腹部有或无病理或临床表现的MWU 四肢，2)进一步确定上肢疼痛的患病率 手动轮椅使用者的病理改变及其与轮椅长度的关系 残疾时间，3)进一步了解进展情况 随着时间的推移，新残疾个体的上肢损伤。 有了这些知识，就有可能改善轮椅的适合性， 以防止受伤的方式进行处方和训练。这些 改进可减少继发性残疾、降低成本和 更有生产力的生活。

Upper extremity pain (UEP) is a substantial problem in individuals who depend on manual wheelchair use for mobility. The prevalence of shoulder pain in manual wheelchair users (MWUs) with spinal cord injuries (SCI) is between 30% and 70% and mononeuropathies such as carpal tunnel syndrome have a prevalence between 40% and 60%. Because the upper extremity is essential for almost all activities in individuals with SCI, UEP can cause serious secondary disability. Research into the cause of UEP has been limited, and virtually no studies have looked at intervention or prevention. In this study we will test the hypothesis that UEP and pathology are related to specific joint angles, moments and force occurring during manual wheelchair propulsion. Our specific aims are: 1) to determine specific biomechanical factors which differentiate MWUs with and without pathological or clinical findings in the upper extremities, 2) to further define the prevalence of upper extremity pain and pathology in manual wheelchair users and its relation to length of time with disability, 3) to gain further insight into the progression over time of upper extremity injuries in individuals with new disability. With this knowledge, it may be possible to improve wheelchair fit, prescription and training in such a way as to prevent injuries. These improvements with lead to less secondary disability, less cost and greater productive life.