Individual Muscle Contributions to Push and Recovery Subtasks During Wheelchair Propulsion

Overview

Journal J Biomech

Specialty Physiology

Date 2011 Mar 15

PMID 21397232

Citations 29

Authors

Jeffery W Rankin

W Mark Richter

Richard R Neptune

Affiliations

Soon will be listed here.

Abstract

Manual wheelchair propulsion places considerable physical demand on the upper extremity and is one of the primary activities associated with the high prevalence of upper extremity overuse injuries and pain among wheelchair users. As a result, recent effort has focused on determining how various propulsion techniques influence upper extremity demand during wheelchair propulsion. However, an important prerequisite for identifying the relationships between propulsion techniques and upper extremity demand is to understand how individual muscles contribute to the mechanical energetics of wheelchair propulsion. The purpose of this study was to use a forward dynamics simulation of wheelchair propulsion to quantify how individual muscles deliver, absorb and/or transfer mechanical power during propulsion. The analysis showed that muscles contribute to either push (i.e., deliver mechanical power to the handrim) or recovery (i.e., reposition the arm) subtasks, with the shoulder flexors being the primary contributors to the push and the shoulder extensors being the primary contributors to the recovery. In addition, significant activity from the shoulder muscles was required during the transition between push and recovery, which resulted in increased co-contraction and upper extremity demand. Thus, strengthening the shoulder flexors and promoting propulsion techniques that improve transition mechanics have much potential to reduce upper extremity demand and improve rehabilitation outcomes.

Citing Articles

Handrim kinetics and quantitative ultrasound parameters for assessment of subacromial impingement in wheelchair users with pediatric-onset spinal cord injury.

Cordes C, Leonardis J, Samet J, Schnorenberg A, England M, Mukherjee S Gait Posture. 2024; 113:561-569.

PMID: 39182433 PMC: 11388546. DOI: 10.1016/j.gaitpost.2024.08.075.

Differences in Glenohumeral Joint Contact Forces Between Recovery Hand Patterns During Wheelchair Propulsion With and Without Shoulder Muscle Weakness: A Simulation Study.

Walford S, Rankin J, Mulroy S, Neptune R J Biomech Eng. 2024; 146(4).

PMID: 38270963 PMC: 10983712. DOI: 10.1115/1.4064590.

Rotator cuff repair in upper extremity ambulators: an assessment of longitudinal outcomes.

Valiquette A, Graf A, Mickschl D, Zganjar A, Grindel S JSES Int. 2022; 6(6):942-947.

PMID: 36353413 PMC: 9637750. DOI: 10.1016/j.jseint.2022.08.015.

Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study.

Roy V, Lee L, Uihlein M, Roy I, Lee K J Spinal Cord Med. 2019; 44(1):29-36.

PMID: 30994414 PMC: 7919900. DOI: 10.1080/10790268.2019.1603898.

Predictors of shoulder pain in manual wheelchair users.

Walford S, Requejo P, Mulroy S, Neptune R Clin Biomech (Bristol). 2019; 65:1-12.

PMID: 30927682 PMC: 6520124. DOI: 10.1016/j.clinbiomech.2019.03.003.

References

de Groot J, Brand R . A three-dimensional regression model of the shoulder rhythm. Clin Biomech (Bristol). 2001; 16(9):735-43. DOI: 10.1016/s0268-0033(01)00065-1. View

Dubowsky S, Sisto S, Langrana N . Comparison of kinematics, kinetics, and EMG throughout wheelchair propulsion in able-bodied and persons with paraplegia: an integrative approach. J Biomech Eng. 2008; 131(2):021015. DOI: 10.1115/1.2900726. View

Goosey-Tolfrey V, Kirk J . Effect of push frequency and strategy variations on economy and perceived exertion during wheelchair propulsion. Eur J Appl Physiol. 2003; 90(1-2):154-8. DOI: 10.1007/s00421-003-0875-6. View

Mulroy S, Farrokhi S, Newsam C, Perry J . Effects of spinal cord injury level on the activity of shoulder muscles during wheelchair propulsion: an electromyographic study. Arch Phys Med Rehabil. 2004; 85(6):925-34. DOI: 10.1016/j.apmr.2003.08.090. View

Gutierrez D, Mulroy S, Newsam C, Gronley J, Perry J . Effect of fore-aft seat position on shoulder demands during wheelchair propulsion: part 2. An electromyographic analysis. J Spinal Cord Med. 2005; 28(3):222-9. DOI: 10.1080/10790268.2005.11753816. View

Morrow M, Hurd W, Kaufman K, An K . Shoulder demands in manual wheelchair users across a spectrum of activities. J Electromyogr Kinesiol. 2009; 20(1):61-7. PMC: 2794990. DOI: 10.1016/j.jelekin.2009.02.001. View

Lin H, Su F, Wu H, An K . Muscle forces analysis in the shoulder mechanism during wheelchair propulsion. Proc Inst Mech Eng H. 2004; 218(4):213-21. DOI: 10.1243/0954411041561027. View

Veeger H, van der Woude L, Rozendal R . Load on the upper extremity in manual wheelchair propulsion. J Electromyogr Kinesiol. 2010; 1(4):270-80. DOI: 10.1016/1050-6411(91)90014-V. View

Boninger M, Cooper R, Baldwin M, Shimada S, Koontz A . Wheelchair pushrim kinetics: body weight and median nerve function. Arch Phys Med Rehabil. 1999; 80(8):910-5. DOI: 10.1016/s0003-9993(99)90082-5. View

10.

Lenton J, van der Woude L, Fowler N, Goosey-Tolfrey V . Effects of arm frequency during synchronous and asynchronous wheelchair propulsion on efficiency. Int J Sports Med. 2009; 30(4):233-9. DOI: 10.1055/s-0028-1105949. View

11.

de Groot S, De Bruin M, Noomen S, van der Woude L . Mechanical efficiency and propulsion technique after 7 weeks of low-intensity wheelchair training. Clin Biomech (Bristol). 2007; 23(4):434-41. DOI: 10.1016/j.clinbiomech.2007.11.001. View

12.

Finley M, Rodgers M . Prevalence and identification of shoulder pathology in athletic and nonathletic wheelchair users with shoulder pain: A pilot study. J Rehabil Res Dev. 2004; 41(3B):395-402. DOI: 10.1682/jrrd.2003.02.0022. View

13.

Neptune R, Kautz S, Zajac F . Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. J Biomech. 2001; 34(11):1387-98. DOI: 10.1016/s0021-9290(01)00105-1. View

14.

Guo L, Su F, An K . Effect of handrim diameter on manual wheelchair propulsion: mechanical energy and power flow analysis. Clin Biomech (Bristol). 2005; 21(2):107-15. DOI: 10.1016/j.clinbiomech.2005.08.015. View

15.

Kwarciak A, Sisto S, Yarossi M, Price R, Komaroff E, Boninger M . Redefining the manual wheelchair stroke cycle: identification and impact of nonpropulsive pushrim contact. Arch Phys Med Rehabil. 2009; 90(1):20-6. DOI: 10.1016/j.apmr.2008.07.013. View

16.

Wu G, van der Helm F, Veeger H, Makhsous M, Van Roy P, Anglin C . ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion--Part II: shoulder, elbow, wrist and hand. J Biomech. 2005; 38(5):981-992. DOI: 10.1016/j.jbiomech.2004.05.042. View

17.

Holzbaur K, Murray W, Delp S . A model of the upper extremity for simulating musculoskeletal surgery and analyzing neuromuscular control. Ann Biomed Eng. 2005; 33(6):829-40. DOI: 10.1007/s10439-005-3320-7. View

18.

Neptune R, Kautz S, Zajac F . Muscle contributions to specific biomechanical functions do not change in forward versus backward pedaling. J Biomech. 2000; 33(2):155-64. DOI: 10.1016/s0021-9290(99)00150-5. View

19.

ROBERTSON R, Boninger M, Cooper R, Shimada S . Pushrim forces and joint kinetics during wheelchair propulsion. Arch Phys Med Rehabil. 1996; 77(9):856-64. DOI: 10.1016/s0003-9993(96)90270-1. View

20.

Happee R, van der Helm F . The control of shoulder muscles during goal directed movements, an inverse dynamic analysis. J Biomech. 1995; 28(10):1179-91. DOI: 10.1016/0021-9290(94)00181-3. View