Shoulder Pain in Persons With Tetraplegia and the Association With Force Application During Manual Wheelchair Propulsion.
Ursina Arnet, Fransiska M Bossuyt, Benjamin J H Beirens and 1 others
PMID 38482105WHAT IT FOUND
Wheelchair users with tetraplegia and high shoulder pain propelled more effectively than those with low pain, using larger push angles and less recovery time.
This contradicts guidelines suggesting poor technique causes pain, indicating pain may lead to protective movement adaptations rather than resulting from them.
Key findings
01Participants with high shoulder pain applied force over a larger push angle and had shorter recovery times compared to those with low pain.
02Force application was more effective in the high pain group, characterized by a lower medial force component.
03There was no significant association between shoulder pain levels and total applied force or the smoothness of force application.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot determine whether the observed biomechanics caused the pain or were a result of it. The sample size was small (n=16 analyzed), limiting the generalizability of the findings. Women were underrepresented in the study population, despite having higher odds for shoulder pain. Data was collected in a laboratory setting, which may not reflect real-life propulsion exposure.
Declared interests
The authors declared no conflicts of interest. Funding and equipment sources included Bonte Technology BV, Three Rivers Holdings, Inc., MathWorks, Inc., and StataCorp LP.
The easy way to misread this
Do not interpret the more efficient propulsion mechanics in the high-pain group as evidence that these techniques prevent shoulder pain. The association is cross-sectional, suggesting pain may cause these adaptations, not that the adaptations caused the pain.