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Load on the shoulder complex during wheelchair propulsion and weight relief lifting

  • S. van Drongelen
    Correspondence
    Corresponding author.
    Affiliations
    Swiss Paraplegic Research, Guido A Zächstrasse 4, 6207 Nottwil, Switzerland

    Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands
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  • L.H.V. van der Woude
    Affiliations
    Center for Human Movement Sciences and Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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  • H.E.J. Veeger
    Affiliations
    Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, The Netherlands

    Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
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      Abstract

      Background

      This study focuses on the relationship between overuse in association with wheelchair activities of daily living and risks for osteoarthrosis in the acromioclavicular and sternoclavicular joints. The aim is to quantify the joint moments and joint reaction forces in all three joints of the shoulder complex during wheelchair-related activities of daily living.

      Methods

      A convenience sample of 17 subjects performed two tasks (wheelchair propulsion and weight relief lifting). Three-dimensional kinematics and kinetics were measured and position and force data were used as input for a musculoskeletal model of the arm and shoulder. Output variables of the model were the moments and the joint reaction forces on the sternoclavicular, acromioclavicular and glenohumeral joints.

      Findings

      Moments on the sternoclavicular joint were higher than on the acromioclavicular and glenohumeral joint, but the joint reaction forces on the sternoclavicular and acromioclavicular joints were only one third of those on the glenohumeral joint (peak forces around 96 N compared to 315 N for wheelchair propulsion and around 330 N compared to 1288 N for weight relief lifting).

      Interpretation

      Based on the results found in this study, net joint moments are likely a better measure to describe the load on the acromioclavicular and sternoclavicular joints due to the passive stabilization. Prospective studies on wheelchair overuse injuries should also look at the acromioclavicular and sternoclavicular joints since the load of wheelchair tasks might be a risk factor for osteoarthrosis in these joints.

      Keywords

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