Kinematics of the wrist, elbow and shoulder during manual wheelchair maneuvers

The objective of this study was to investigate the kinematics of the wrist, elbow and shoulder during manual wheelchair maneuvers. A high incidence of musculoskeletal injuries has been reported due to the overuse and high repetitive motion of wrist, elbow and shoulder during wheelchair propulsion. Studies have been conducted with the use of a dynamometer or treadmill to simulate propulsion on level or inclined surface. However, during indoor maneuvering, turning and initiation of wheelchair movement is unavoidable. Six unimpaired subjects and six spinal cord injured subjects were recruited to perform three types of wheelchair maneuvers: straight-line wheelchair propulsion, turning and initiation of wheelchair movement with their comfortable speed. Using the motion analysis system (Vicon 370, Oxford), upper extremity kinematics were determined. Two general findings were indicated from the results: a) the joint movement were highest during straight-line propulsion when compared with turning motion; and b) the joint movement among the SCI subjects were higher than those of the unimpaired subjects during wheelchair maneuvers.