Article

The purpose of the study was to determine whether wheelchair-based circuit
resistance training (CRT) exercises place the shoulder at risk for mechanical
impingement. Using a novel approach, we created a mechanical impingement risk
score for each exercise by combining scapular and glenohumeral kinematic and
exposure data. In a case series design, 18 individuals (25-76 yr old) with
paraplegia and without substantial shoulder pain participated. The mean
mechanical impingement risk scores at 45-60 degrees humerothoracic elevation were
rank-ordered from lowest to highest risk as per subacromial mechanical
impingement risk: overhead press (0.6 +/- 0.5 points), lat pulldown (1.2 +/- 0.5
points), chest press (2.4 +/- 2.8 points), row (2.7 +/- 1.6 points), and rickshaw
(3.4 +/- 2.3 points). The mean mechanical impingement risk scores at 105-120
degrees humerothoracic elevation were rank-ordered from lowest to highest risk as
per internal mechanical impingement risk: lat pulldown (1.2 +/- 0.5 points) and
overhead press (1.3 +/- 0.5 points). In conclusion, mechanical impingement risk
scores provided a mechanism to capture risk associated with CRT. The rickshaw had
the highest subacromial mechanical risk, whereas the overhead press and lat
pulldown had the highest internal mechanical impingement risk. The rickshaw was
highlighted as the most concerning exercise because it had the greatest
combination of magnitude and exposure corresponding with increased subacromial
mechanical impingement risk.

Langue : ANGLAIS