INTERVENTIONS FOR SCI SHOULDER FUNCTION IN WHEELCHAIRS

描述：（逐字从应用程序）今天，增加寿命和 脊髓损伤（SCI）患者的活动性导致残疾 肩痛成为一个重要的临床问题， 轮椅推进（WCP）的需求。该项目的目标将是 制定指导方针，减少WCP期间对肩部的要求 对于SCI患者。具体而言，目的是确定 水平轮椅座椅位置的变化和肌肉强化 运动干预对肩关节力量和肌肉活动的影响 完全性SCI截瘫和四肢瘫患者的WCP。受试者 无肩关节疼痛症状的SCI患者和报告肩关节疼痛的患者 将测试WCP期间的疼痛。参加者将根据SCI分组 损伤水平（截瘫、C7四肢瘫痪和C6四肢瘫痪）。受试者将 轮椅上有一个测力计，在三个水平的座位上 在自由和快速的速度和模拟的百分之八的倾斜位置。 受试者将在三个座椅位置保持固定速度， 推进条件。冈上肌，冈下肌， 肩胛肌，三角肌前和中，胸骨前锯肌 记录胸大肌、中下斜肌和大菱形肌 使用肌内细线电极进行动态EMG。运动 将使用Vicon Motion测量肩关节、肘关节和腕关节 分析系统WCP力将用应变计记录， 盘矢状面和肩胛面的最大等长肩抬高 （肩关节）、肩内收和内外旋扭矩将 用激光测力计测量。受试者的一个小组将 参加为期12周的肩部肌肉强化和柔韧性锻炼 程序.不参加锻炼计划的受试者将 作为对照组。运动组和对照组受试者每隔一周 三个星期的力量评估。强度和推进力测试 在12周周期结束时对所有受试者重复。数据将 分析比较肩关节的力量，力矩，肌肉的模式 WCP期间三种座椅位置的肩痛活动和报告 以及锻炼计划前后的情况的统计显著性 结果将通过重复测量MANOVA分析确定， SCI水平和运动/对照组的因素。

DESCRIPTION: (verbatim from the application) Today, the increased longevity and mobility of individuals with spinal cord injury (SCI) has led to disabling shoulder pain becoming a significant clinical problem which has been related to the demands of wheelchair propulsion (WCP). The goal of this project will be to develop guidelines for the reduction of the demands on the shoulder during WCP for persons with SCI. Specifically, the aims are to determine the effects of changes in the horizontal wheelchair seat position and a muscle strengthening exercise intervention on the shoulder joint forces and muscle activity during WCP in persons with paraplegia and tetraplegia from complete SCI. Subjects with SCI who are asymptomatic for shoulder joint pain and those who report shoulder pain during WCP will be tested. Participants will be grouped according to SCI level of injury (paraplegia, C7 tetraplegia and C6 tetraplegia). Subjects will wheel their chairs, on a wheelchair ergometer in three horizontal seat positions at free and fast velocities and on a simulated 8 percent incline. Subjects will maintain fixed velocities in the three seat positions for each propulsion condition. Function of the supraspinatus, infraspinatus, sbscapularis, anterior and middle deltoid, serratus anterior, sternal pectoralis major, middle and lower rapezius and rhomboid major will be recorded with dynamic EMG using intramuscular fine wire electrodes. Motion of the shoulder, elbow and wrist joints will be measured with the Vicon Motion Analysis System. WCP forces will be recorded with a strain gauge instrumented wheel. Maximal isometric shoulder elevation in the sagittal and scapular planes (scaption), shoulder adduction and internal and external rotation torques will be measured with a LIDO dynamometer. A sub‑group of the subjects will participate in a 12 week shoulder muscle strengthening and flexibility exercise program. Those subjects who do not participate in the exercise program will serve as a control group. Both exercise and control subjects will return every three weeks for strength assessment. The strength and propulsion tests will be repeated for all subjects at the end of the 12 week period. The data will be analyzed to compare the shoulder joint forces, moments, patterns of muscle activity and reports of shoulder pain during WCP in the three seat positions and before and after the exercise program. Statistical significance of the findings will be determined by repeated measures MANOVA analyses with grouping factors for SCI level and exercise/control groups.