Compensation strategies in response to fatiguing propulsion in wheelchair users: Implications for shoulder injury risk

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J83058

Journal:

American Journal of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2020 , 99, 2, 91-98

Publication Website:

Abstract:

Study investigated whether fatigue-inducing wheelchair propulsion changes neuromuscular activation and propulsion biomechanics and identified variables predicting susceptibility to fatigue. Muscular activation and propulsion biomechanics during treadmill propulsion at 25W and 45W were assessed before and after a protocol designed to cause fatigue in 34 wheelchair users with a spinal cord injury. With the induced fatigue, wheelchair users propelled with increased muscular activation in the pectoralis major pars sternalis, deltoideus pars acormialis and upper trapezius (45W) and a slightly reduced push angle (25W: 75 to 74 degrees; 45W: 78 to 76 degrees). Wheelchair users susceptible to fatigue were more often complete, injured at an older age and had less years since injury. This group propelled in general with shorter push angle and greater maximum resultant force, had a greater anaerobic capacity and less muscular activation. Compensation strategies in response to fatiguing propulsion could increase the risk of shoulder injury. Predictor variables of susceptibility to fatigue inform interventions preserving shoulder health and include lesion characteristics, propulsion technique, anaerobic capacity, and muscular activation.

Author(s):