Compensation Strategies in Response to Fatiguing Propulsion in Wheelchair Users: Implications for Shoulder Injury Risk.
Journal
American journal of physical medicine & rehabilitation
ISSN: 1537-7385
Titre abrégé: Am J Phys Med Rehabil
Pays: United States
ID NLM: 8803677
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
pubmed:
25
7
2019
medline:
22
12
2020
entrez:
24
7
2019
Statut:
ppublish
Résumé
The aims of the study were to examine whether fatigue-inducing wheelchair propulsion changes neuromuscular activation and propulsion biomechanics and to determine predictor variables for susceptibility to fatigue. This study with a quasi-experimental, one-group, pretest-posttest design investigates a population-based sample of wheelchair users with a spinal cord injury (n = 34, age: 50.8 ± 9.7 yrs, 82% males). Neuromuscular activation and propulsion biomechanics during treadmill propulsion at 25 W and 45 W were assessed before and after a protocol designed to cause fatigue. With the induced fatigue, wheelchair users propelled with increased neuromuscular activation in the pectoralis major pars sternalis, deltoideus pars acromialis and upper trapezius (45 W, P < 0.05), and a slightly reduced push angle (25 W: 75-74 degrees, P < 0.05, 45 W: 78-76 degrees, P < 0.05). Wheelchair users susceptible to fatigue (47%) were more likely to have a complete lesion, to be injured at an older age, and had less years since injury. This group propelled in general with shorter push angle and greater maximum resultant force, had a greater anaerobic capacity, and had less neuromuscular activation. Compensation strategies in response to fatiguing propulsion could increase the risk for shoulder injury. Predictor variables for susceptibility to fatigue inform interventions preserving shoulder health and include lesion characteristics, propulsion technique, anaerobic capacity, and neuromuscular activation. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Explain a neuromuscular compensation strategy and the corresponding muscles in response to fatiguing wheelchair propulsion; (2) Recommend propulsion biomechanics associated to reduced susceptibly to fatiguing wheelchair propulsion; and (3) List examples of predictor variables of susceptibility to fatigue. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Identifiants
pubmed: 31335344
doi: 10.1097/PHM.0000000000001267
pii: 00002060-202002000-00001
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-98Références
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