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Ascending curbs of progressively higher height increases forward trunk flexion along with upper extremity mechanical and muscular demands in manual wheelchair users with a spinal cord injury.
J Electromyogr Kinesiol. 2013 Dec; 23(6):1434-45.JE

Abstract

High upper extremity (U/E) demands are required when manual wheelchair users (MWUs) with spinal cord injury (SCI) ascend curbs; this may contribute to the risk of developing U/E musculoskeletal impairments. The aim of this study was to compare movement strategies (kinematics), mechanical loads (kinetics) and muscular demand (EMG) at the non-dominant U/E among 15 MWUs with SCI when ascending curbs of 4 cm (3 trials), 8 cm (3 trials) and 12 cm high (3 trials) from a starting line set 3 m before the curb. Biomechanical data was collected during three trials for each height. The curb ascent task was divided into three adjustment phases: caster pop, rear-wheel ascent and post-ascent. The greatest effort was generated by the shoulder flexors and internal rotators as well as the elbow flexors. A significant difference (p < 0.0167) between the curb heights was found for most outcome measures studied: movement excursion, net joint moments and muscular utilization ratio (MUR) of the main muscles increased with the higher curb heights, mainly around the shoulder joint. These results provide insight that aside from adhering to a highly structured training method for wheelchair curb ascent, rehabilitation professionals need to propose task-specific strength training programs based on the demands documented in this study and continue to advocate for physically accessible environments.

Authors+Show Affiliations

School of Rehabilitation, Université de Montréal, Montreal, QC, Canada(1); Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut de réadaptation Gingras-Lindsay-de-Montréal, Montreal, QC, Canada(2).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23866992

Citation

Lalumiere, Mathieu, et al. "Ascending Curbs of Progressively Higher Height Increases Forward Trunk Flexion Along With Upper Extremity Mechanical and Muscular Demands in Manual Wheelchair Users With a Spinal Cord Injury." Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, vol. 23, no. 6, 2013, pp. 1434-45.
Lalumiere M, Gagnon DH, Hassan J, et al. Ascending curbs of progressively higher height increases forward trunk flexion along with upper extremity mechanical and muscular demands in manual wheelchair users with a spinal cord injury. J Electromyogr Kinesiol. 2013;23(6):1434-45.
Lalumiere, M., Gagnon, D. H., Hassan, J., Desroches, G., Zory, R., & Pradon, D. (2013). Ascending curbs of progressively higher height increases forward trunk flexion along with upper extremity mechanical and muscular demands in manual wheelchair users with a spinal cord injury. Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology, 23(6), 1434-45. https://doi.org/10.1016/j.jelekin.2013.06.009
Lalumiere M, et al. Ascending Curbs of Progressively Higher Height Increases Forward Trunk Flexion Along With Upper Extremity Mechanical and Muscular Demands in Manual Wheelchair Users With a Spinal Cord Injury. J Electromyogr Kinesiol. 2013;23(6):1434-45. PubMed PMID: 23866992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ascending curbs of progressively higher height increases forward trunk flexion along with upper extremity mechanical and muscular demands in manual wheelchair users with a spinal cord injury. AU - Lalumiere,Mathieu, AU - Gagnon,Dany H, AU - Hassan,Jessica, AU - Desroches,Guillaume, AU - Zory,Raphael, AU - Pradon,Didier, Y1 - 2013/07/16/ PY - 2012/11/23/received PY - 2013/05/20/revised PY - 2013/06/05/accepted PY - 2013/7/23/entrez PY - 2013/7/23/pubmed PY - 2014/7/6/medline KW - Activities of daily living KW - Electromyography KW - Kinematic KW - Kinetics KW - Rehabilitation KW - Spinal cord injuries KW - Task performance and analysis KW - Wheelchair SP - 1434 EP - 45 JF - Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology JO - J Electromyogr Kinesiol VL - 23 IS - 6 N2 - High upper extremity (U/E) demands are required when manual wheelchair users (MWUs) with spinal cord injury (SCI) ascend curbs; this may contribute to the risk of developing U/E musculoskeletal impairments. The aim of this study was to compare movement strategies (kinematics), mechanical loads (kinetics) and muscular demand (EMG) at the non-dominant U/E among 15 MWUs with SCI when ascending curbs of 4 cm (3 trials), 8 cm (3 trials) and 12 cm high (3 trials) from a starting line set 3 m before the curb. Biomechanical data was collected during three trials for each height. The curb ascent task was divided into three adjustment phases: caster pop, rear-wheel ascent and post-ascent. The greatest effort was generated by the shoulder flexors and internal rotators as well as the elbow flexors. A significant difference (p < 0.0167) between the curb heights was found for most outcome measures studied: movement excursion, net joint moments and muscular utilization ratio (MUR) of the main muscles increased with the higher curb heights, mainly around the shoulder joint. These results provide insight that aside from adhering to a highly structured training method for wheelchair curb ascent, rehabilitation professionals need to propose task-specific strength training programs based on the demands documented in this study and continue to advocate for physically accessible environments. SN - 1873-5711 UR - https://www.unboundmedicine.com/medline/citation/23866992/Ascending_curbs_of_progressively_higher_height_increases_forward_trunk_flexion_along_with_upper_extremity_mechanical_and_muscular_demands_in_manual_wheelchair_users_with_a_spinal_cord_injury_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1050-6411(13)00156-9 DB - PRIME DP - Unbound Medicine ER -