INTERVENTIONS FOR SCI SHOULDER FUNCTION IN WHEELCHAIRS

描述：(来自应用程序的逐字)今天，增加的寿命和 脊髓损伤(SCI)患者的活动能力已导致残疾 肩痛成为一个重要的临床问题，这与 轮椅推进(WCP)的要求。该项目的目标将是 制定在WCP期间减少肩部需求的指导方针 适用于脊髓损伤患者。具体地说，目标是确定 轮椅水平坐姿的变化与肌肉强化 运动干预对大鼠肩关节力和肌肉活动的影响 完全性脊髓损伤后截瘫和四肢瘫患者的WCP。研究对象： 肩关节疼痛无症状的脊髓损伤和报告肩部疼痛的人 WCP期间的疼痛将进行测试。参赛者将根据SCI进行分组 损伤程度(截瘫、C7四肢瘫痪、C6四肢瘫痪)。研究对象将 在轮椅测功器上推动他们的椅子，放在三个水平座位上 在自由和快速的速度和模拟的8%倾斜的位置。 受试者将在三个座位位置上保持固定的速度 推进状态。冈上肌、冈下肌的功能， 肩胛肌、三角肌前中部、前锯齿肌、胸骨 将记录胸大肌、中、下斜方肌和菱形大肌 使用肌肉内细丝电极进行动态肌电检查。议事日程的动议 肩部、肘部和手腕关节将使用维康运动进行测量 分析系统。WCP力将用仪表式应变仪记录 方向盘。矢状面和肩胛面的最大等长肩高 (肩关节)、肩关节内收和内外旋转力 使用LIDO测功机进行测量。一组受试者将参加 参加为期12周的肩部肌肉强化和柔韧性训练 程序。那些没有参加锻炼计划的受试者将 作为对照组。运动受试者和对照受试者都将在 三周时间进行体能评估。强度和推进力测试将是 在12周结束时，对所有受试者重复试验。数据将是 分析比较肩关节力、力矩、肌肉形态 WCP中三种坐位肩部疼痛的活动性和报告 以及锻炼计划前后的情况。数据的统计意义 结果将通过重复测量Manova分析和分组来确定 影响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.