Upper extremity pain (UEP) is a substantial problem in individuals who depend on manual wheelchair use for mobility. The prevalence of shoulder pain in manual wheelchair users (MWUs) with spinal cord injuries (SCI) is between 30% and 70% and mononeuropathies such as carpal tunnel syndrome have a prevalence between 40% and 60%. Because the upper extremity is essential for almost all activities in individuals with SCI, UEP can cause serious secondary disability. Research into the cause of UEP has been limited, and virtually no studies have looked at intervention or prevention. In this study we will test the hypothesis that UEP and pathology are related to specific joint angles, moments and force occurring during manual wheelchair propulsion.
Our specific aims are: 1) to determine specific biomechanical factors which differentiate MWUs with and without pathological or clinical findings in the upper extremities, 2) to further define the prevalence of upper extremity pain and pathology in manual wheelchair users and its relation to length of time with disability, 3) to gain further insight into the progression over time of upper extremity injuries in individuals with new disability. With this knowledge, it may be possible to improve wheelchair fit, prescription and training in such a way as to prevent injuries. These improvements with lead to less secondary disability, less cost and greater productive life.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HD001122-03
Application #
2402974
Study Section
Special Emphasis Panel (SRC (08))
Project Start
1995-09-25
Project End
2000-08-31
Budget Start
1997-09-01
Budget End
1998-08-31
Support Year
3
Fiscal Year
1997
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Orthopedics
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Cooper, Rory A (2009) SMARTWheel: From concept to clinical practice. Prosthet Orthot Int 33:198-209
Boninger, Michael L; Koontz, Alicia M; Sisto, Sue Ann et al. (2005) Pushrim biomechanics and injury prevention in spinal cord injury: recommendations based on CULP-SCI investigations. J Rehabil Res Dev 42:9-19
O'Connor, Thomas J; Fitzgerald, Shirley G; Cooper, Rory A et al. (2002) Kinetic and physiological analysis of the GAME(Wheels) system. J Rehabil Res Dev 39:627-34
Koontz, Alicia M; Cooper, Rory A; Boninger, Michael L et al. (2002) Shoulder kinematics and kinetics during two speeds of wheelchair propulsion. J Rehabil Res Dev 39:635-49
Boninger, M L; Towers, J D; Cooper, R A et al. (2001) Shoulder imaging abnormalities in individuals with paraplegia. J Rehabil Res Dev 38:401-8
Boninger, M L; Baldwin, M; Cooper, R A et al. (2000) Manual wheelchair pushrim biomechanics and axle position. Arch Phys Med Rehabil 81:608-13
Boninger, M L; Cooper, R A; Baldwin, M A et al. (1999) Wheelchair pushrim kinetics: body weight and median nerve function. Arch Phys Med Rehabil 80:910-5
Boninger, M L; Saur, T; Trefler, E et al. (1998) Postural changes with aging in tetraplegia: effects on life satisfaction and pain. Arch Phys Med Rehabil 79:1577-81
Cooper, R A; Boninger, M L; VanSickle, D P et al. (1997) Uncertainty analysis for wheelchair propulsion dynamics. IEEE Trans Rehabil Eng 5:130-9
Cooper, R A; Gonzalez, J; Lawrence, B et al. (1997) Performance of selected lightweight wheelchairs on ANSI/RESNA tests. American National Standards Institute-Rehabilitation Engineering and Assistive Technology Society of North America. Arch Phys Med Rehabil 78:1138-44

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