Short Title:Journal of Spinal Cord Medicine - JSCM (formerly Journal of the American Paraplegia Society)
Year, Volume, Issue, Page(s):15, 38, 4, 485-497
Study compared the effects of three wheelchair transfer techniques on the upper-extremity (UE) joint kinetics of manual wheelchair users with spinal cord injury (SCI). Twenty individuals with SCI performed three sitting-pivotal transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head-hips relationship where the trunk was forward flexed with the leading hand close to the body and internally rotated (HH-I) and with the leading hand abducted and far away (HH-A) from the body. The third technique was performed with the trunk upright (TU) and the hand far from the body. Motion analysis equipment recorded upper-body movements and force sensors recorded their hand and feet reaction forces during the transfers. Results showed several significant differences between HH-A and HH-I and between TU and HH-I transfers, suggesting that hand placement had a greater effect on the UE kinetics than did the amount of trunk flexion. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm and lower at the leading arm, compared to the HH-I technique. Findings suggest that always trailing with the same arm if using HH-A or TU could predispose that arm to overuse-related pain and injuries. The authors conclude that technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement.