Background/Purpose: Spinal cord injured (SCI) patients who are full time manual wheelchair users often suffer from shoulder pain. Research suggests that the etiology of this pain can be from wheelchair propulsion when using a standard handrim wheelchair. The purpose of this capstone project is to review the literature on alternative wheelchair propulsion methods, specifically a lever-activated wheelchair, and its ability to prevent shoulder pathology compared to a standard handrim wheelchair. Case Description: Mr. R is a 46 year old male with a SCI at the level of T6. Mr. R is considered an ASIA A SCI after he traumatically injured his spinal cord at T6 during a snowmobile accident. Mr. R has had multiple procedures done for his shoulder including surgery to repair rotator cuff damage, injections for bursitis, and physical therapy for strengthening. Pain relief was temporary using these methods and a permanent solution has not been found. Outcomes: Research specifically relating to the lever-activated wheelchair is scarce. One study was found that directly related. Requejo et. al found that the lever activated wheelchair decreased muscle activity in supraspinatus by a peak of 50% and increased distance per stroke from .84m to 1.01m . Several other studies found that mechanical advantage and increasing efficiency during wheelchair propulsion decreased pain in the shoulder and increased social participation and quality of life. Discussion: A lever-activated wheelchair can prevent shoulder pathology better than a standard handrim wheelchair. By decreasing supraspinatus activity, increasing mechanical advantage, increasing muscular efficiency, and decreasing strokes per day, a patient with a SCI can expect to prevent shoulder pathology or decrease current pain. By decreasing pain, these patients can increase quality of life and maintain or regain their independence.
Submitted by Bryan Johnston (email@example.com) on 2014-06-25T19:31:57Z No. of bitstreams: 1 Complete Capstone2.pdf: 1895236 bytes, checksum: bf92aeeb203b12d95f015332308f0ee9 (MD5), Made available in DSpace on 2014-06-25T19:31:57Z (GMT). No. of bitstreams: 1 Complete Capstone2.pdf: 1895236 bytes, checksum: bf92aeeb203b12d95f015332308f0ee9 (MD5)
Spinal Cord Injury, Lever Wheelchair, Shoulder Pathology
Johnston, Bryan. "Does a lever-activated manual wheelchair decrease incidence of shoulder pathology greater than a manual handrim wheel chair in mid thoracic and above level spinal cord injured patients?." (2014). http://digitalrepository.unm.edu/dpt/87
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