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Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility.
J Biomech. 2014 Jan 03; 47(1):269-76.JB

Abstract

Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood.

Authors+Show Affiliations

Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA. Electronic address: paulaj@uwm.edu.Department of Occupational Science & Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA; Shriners Hospitals for Children, Chicago, IL, USA.Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA; Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.Shriners Hospitals for Children, Chicago, IL, USA.Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA; Shriners Hospitals for Children, Chicago, IL, USA.Orthopaedic and Rehabilitation Engineering Center (OREC), Marquette University/Medical College of Wisconsin, Milwaukee, WI, USA; Department of Biomedical Engineering, Marquette University, Milwaukee, WI, USA; Shriners Hospitals for Children, Chicago, IL, USA; Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.

Pub Type(s)

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

Language

eng

PubMed ID

24309622

Citation

Schnorenberg, Alyssa J., et al. "Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics During Wheelchair Mobility." Journal of Biomechanics, vol. 47, no. 1, 2014, pp. 269-76.
Schnorenberg AJ, Slavens BA, Wang M, et al. Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility. J Biomech. 2014;47(1):269-76.
Schnorenberg, A. J., Slavens, B. A., Wang, M., Vogel, L. C., Smith, P. A., & Harris, G. F. (2014). Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility. Journal of Biomechanics, 47(1), 269-76. https://doi.org/10.1016/j.jbiomech.2013.11.014
Schnorenberg AJ, et al. Biomechanical Model for Evaluation of Pediatric Upper Extremity Joint Dynamics During Wheelchair Mobility. J Biomech. 2014 Jan 3;47(1):269-76. PubMed PMID: 24309622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biomechanical model for evaluation of pediatric upper extremity joint dynamics during wheelchair mobility. AU - Schnorenberg,Alyssa J, AU - Slavens,Brooke A, AU - Wang,Mei, AU - Vogel,Lawrence C, AU - Smith,Peter A, AU - Harris,Gerald F, Y1 - 2013/11/20/ PY - 2013/05/21/received PY - 2013/11/05/revised PY - 2013/11/06/accepted PY - 2013/12/7/entrez PY - 2013/12/7/pubmed PY - 2014/10/19/medline KW - Biomechanics KW - Inverse dynamics KW - Manual wheelchair KW - Pediatric KW - Upper extremity SP - 269 EP - 76 JF - Journal of biomechanics JO - J Biomech VL - 47 IS - 1 N2 - Pediatric manual wheelchair users (MWU) require high joint demands on their upper extremity (UE) during wheelchair mobility, leading them to be at risk of developing pain and pathology. Studies have examined UE biomechanics during wheelchair mobility in the adult population; however, current methods for evaluating UE joint dynamics of pediatric MWU are limited. An inverse dynamics model is proposed to characterize three-dimensional UE joint kinematics and kinetics during pediatric wheelchair mobility using a SmartWheel instrumented handrim system. The bilateral model comprises thorax, clavicle, scapula, upper arm, forearm, and hand segments and includes the sternoclavicular, acromioclavicular, glenohumeral, elbow and wrist joints. A single 17 year-old male with a C7 spinal cord injury (SCI) was evaluated while propelling his wheelchair across a 15-meter walkway. The subject exhibited wrist extension angles up to 60°, large elbow ranges of motion and peak glenohumeral joint forces up to 10% body weight. Statistically significant asymmetry of the wrist, elbow, glenohumeral and acromioclavicular joints was detected by the model. As demonstrated, the custom bilateral UE pediatric model may provide considerable quantitative insight into UE joint dynamics to improve wheelchair prescription, training, rehabilitation and long-term care of children with orthopedic disabilities. Further research is warranted to evaluate pediatric wheelchair mobility in a larger population of children with SCI to investigate correlations to pain, function and transitional changes to adulthood. SN - 1873-2380 UR - https://www.unboundmedicine.com/medline/citation/24309622/Biomechanical_model_for_evaluation_of_pediatric_upper_extremity_joint_dynamics_during_wheelchair_mobility_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0021-9290(13)00566-6 DB - PRIME DP - Unbound Medicine ER -