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Increased Seat Dump Angle in a Manual Wheelchair Is Associated With Changes in Thoracolumbar Lordosis and Scapular Kinematics During Propulsion

CLOUD BA; ZHAO KD; ELLINGSON AM; NASSR A; WINDEBANK AJ; AN KN
ARCH PHYS MED REHABIL , 2017, vol. 98, n° 10, p. 2021-2027
Doc n°: 186197
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.apmr.2017.02.014
Descripteurs : CB4 - LORDOSE, KF62 - FAUTEUIL MANUEL

OBJECTIVE: To quantify and compare spinal curvature and shoulder kinematics
throughout the manual wheelchair (MWC) propulsion cycle for individuals with
spinal cord injury (SCI) who were seated at 2 different seat dump angles. DESIGN:
Single-group, repeated-measures study. SETTING: Academic medical center.
PARTICIPANTS: Individuals (N=28) with SCI or spinal cord disease who used MWCs
completed a telephone screening, and 21 of them were eligible and completed the
study. INTERVENTIONS: Participants' personal MWCs were modified to have seat dump
angles of 0 degrees or 14 degrees , with a vertical backrest. Participants
completed at least 3 propulsion cycles in each condition, during which spine and
shoulder motion data were collected with fiberoptic and electromagnetic sensors,
respectively. MAIN OUTCOME MEASURES: Thoracolumbar spinal curvature, glenohumeral
kinematics, and scapulothoracic kinematics at the start of push (SP), mid-push
(MP), end of push (EP), and mid-recovery. RESULTS: Participants had significantly
less lordosis in the 14 degrees condition for all propulsion events. Median
differences ranged from 2.0 degrees to 4.6 degrees . Lordosis differences were
more pronounced in those with low SCI. Scapulothoracic internal rotation was
increased in the 14 degrees condition at SP and MP (mean differences, 2.5 degrees
and 2.7 degrees , respectively). Relative downward rotation increased in the 14
degrees condition at SP and MP (mean differences, 2.4 degrees and 2.1 degrees ,
respectively). Scapulothoracic differences were more pronounced in those with
high SCI. No glenohumeral rotations were significantly different between the
conditions. CONCLUSIONS: Scapulothoracic kinematics and spinal curvature
differences during propulsion may be associated with the position of other body
segments or postural stability. Because no differences were observed at the
glenohumeral joint, the risk of subacromial impingement may not be affected by
this seat angle change.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS

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