Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
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Upper Extremity Biomechanics of Manual Wheelchair Propulsion at Different Speeds

수동 휠체어 추진 속도에 따른 상지 관절 생체역학적 영향 분석

  • Hwang, Seonhong (Department of Physical Therapy, College of Life and Health Science, Hoseo Univ., Smart Healthcare Convergence Research Center, Hoseo Univ., Institute of Basic Science Research, Hoseo Univ.)
  • 황선홍 (호서대학교 생명보건대학 물리치료학과, 호서대학교 스마트헬스케어융복합연구센터, 호서대학교 기초과학연구소)
  • Received : 2022.07.19
  • Accepted : 2022.08.11
  • Published : 2022.08.31
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Abstract

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (GE) and 27 healthy adults for the control group (GC) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in GE; 20.24 deg in GC) and elbow (5.25 deg in GE; 2.57 deg in GC) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of GE was already narrowed by about 60% compared to the GC from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

Keywords

Acknowledgement

This research was supported by the Academic Research Fund of Hoseo University in 2021 (20210483).

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