Effect of Fatiguing Wheelchair Propulsion and Weight Relief Lifts on Subacromial Space in Wheelchair Users.
Ursina Arnet, Michael L Boninger, Ann Cools and 1 others
PMID 36189050WHAT IT FOUND
Wheelchair users with spinal cord injury had a narrowed subacromial space during weight relief lifts, especially those with low anaerobic capacity.
However, fatiguing wheelchair propulsion did not change the space or tendon compression ratios, suggesting daily propulsion alone does not cause immediate narrowing.
Key findings
01Weight relief lifts significantly reduced the acromiohumeral distance compared to the unloaded position, indicating temporary narrowing of the subacromial space.
02This reduction in space during weight relief lifts was primarily seen in participants with lower anaerobic work capacity, while those with higher capacity maintained their space.
03Fatiguing wheelchair propulsion had no significant effect on the acromiohumeral distance or the occupation ratio of the supraspinatus and biceps tendons.
STILL TO COME
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What it does not show
The study excluded participants with upper-extremity pain that limits wheelchair propulsion, so results may not apply to those with existing shoulder pain. The fatiguing intervention used maximum voluntary propulsion, which may be more demanding than typical daily activities. Ultrasound measurements of AHD and tendon thickness were taken from different images and arm positions, which may affect the accuracy of the occupation ratio calculation. The study did not measure the occupation ratio during weight relief lifts, limiting the understanding of tendon compression under load. Participants may still have had pain that did not limit propulsion, which could influence the results.
Declared interests
The authors declare no commercial or financial relationships. Swiss Paraplegic Research paid the open access publication fee. The handling editor declared a past co-authorship with one of the authors.
The easy way to misread this
Do not assume that weight relief lifts are safe for all wheelchair users. The study found that these lifts significantly narrowed the subacromial space, particularly in individuals with low anaerobic work capacity, suggesting a potential risk for shoulder impingement in this subgroup.