WHEELCHAIR PROPULSION BIOMECHANICS AND ARM PAIN

上肢疼痛（UEP）是一个严重的问题，在个人谁 依靠手动轮椅来移动。肩关节的患病率 脊髓损伤（SCI）手动轮椅使用者（MWU）的疼痛 在30%到70%之间， 综合征患病率在40%到60%之间。因为上 肢体对于SCI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。原因研究 UEP是有限的，几乎没有研究关注 干预或预防。在这项研究中，我们将测试假设 UEP和病理学与特定的关节角度、力矩和 在手动轮椅推进过程中产生的力。我们的具体目标 是：1）以确定具体的生物力学因素，区分 上腹部有和无病理或临床发现的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学及其与 残疾时间，3）进一步了解进展 随着时间的推移，上肢损伤的个人与新的残疾。 有了这些知识，就有可能改善轮椅的适应性， 处方和培训，以防止受伤。这些 改善导致更少的二次残疾，更少的成本， 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.