PTCohortGait & posture2024

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

Caleb M A Cordes, Joshua M Leonardis, Jonathan Samet and 6 others

PMID 39182433

WHAT IT FOUND

In 11 wheelchair users with pediatric-onset SCI, greater variability in propulsion force was linked to a thicker supraspinatus tendon, while higher force application effectiveness was linked to a thinner tendon.

These relationships were inconsistent and did not establish a clear protective mechanism.

Key findings

01Coefficient of variation of peak resultant force increased 3.6% for every 0.1 cm increase in supraspinatus tendon thickness.

02Fractional effective force decreased 3.45% for every 0.1 cm increase in supraspinatus tendon thickness.

03Coefficient of variation of fractional effective force decreased 11.6% for every 0.1 cm increase in supraspinatus tendon thickness.

STILL TO COME

How it was doneWhat they found

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What it does not show

The sample size was very small (11 participants), limiting the generalizability of the findings. The study design was correlational, so it cannot prove that handrim kinetics cause changes in shoulder structure or vice versa. Participants reported minimal-to-none shoulder pain, so the findings may not apply to those with active pain or pathology. The ultrasound measures were compared against adult norms or healthy controls, as typical values for pediatric wheelchair users are not established. The study only examined the dominant shoulder.

The easy way to misread this

Do not interpret the association between force variability and tendon thickness as evidence that specific propulsion training prevents shoulder injury. The study found mixed relationships in a small group of pain-free participants, and it did not measure clinical outcomes or establish causation.

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