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Effect of two-speed manual wheelchair wheel on shoulder pain in wheelchair users

pirs dva

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INTRODUCTION

  • Manual wheelchair users (MWCU) depend on their upper extremities for mobility, transfers, pressure relief and a variety of other daily functional activities.
  • Dependence on limbs not designed for heavy repetitive loading predisposes manual wheelchair users to debilitating upper extremity problems .
  • Up to 80% of today’s manual wheelchair users suffer from shoulder pain1.
  • The purpose of this study is to investigate the impact of a new manual 2-speed wheelchair wheel (MAGICWHEELS™ , Seattle, WA, Figure 1) on shoulder pain in  manual wheelchair users .

METHODS
  • Participants: 17 MWCU with shoulder pain (WUSPI score >10)
- Age: 46.0±14.0 years
- Duration WC use: 15.1±10.1 years
- Gender: Male=9 ; Female =8
- Disabilities: spina bifida(1) ;SCI (11); post-polio(1);stroke (1);ataxia (1);Rheumatoid
   arthritis(1);spinal stenosis(1)
- Phase I (baseline): one month using personal wheelchair wheels
- Phase II: five months with the MAGICWHEELS- 2-speed wheels attached to
  personal wheelchair
- Phase III (retention): one month in personal wheelchair with personal wheels

Figure 1: Subject using MAGICWHEELS 2-speed wheels

shoulder_pain_wheelchair



OUTCOME MEASURES
  • Repeated Wheelchair Users Shoulder Pain Index (WUSPI) surveys2,3 weekly during each Phase
  • Pre-post Wheelchair Users Functional Assessment tests (WUFA)4
  • Timed hill climbing using PW and 2-speed wheels with reported Relative Perceived Exertion (RPE):

RESULTS

  • Phase I (baseline): Repeated WUSPI indicated stability in shoulder pain without application of an intervention (p=0.40).
  • Phase II: Significant reduction (percentage of baseline) in shoulder pain with the 2-gear wheel intervention was found at week 2 (p=0.004) and continued at every week through week 16 (p=0.015)
wuspi
  • No difference in WUFA scores following the five month use of theMAGICWHEELS 2-geared wheelchair wheel, however, there was a strong trend noted towards an improvement in function. (pre= 79.2 ±0.41, post= 80.7 ± 0.55 p=0.06).
  • Hill test using MAGICWHEELS 2-speed wheels in a 2:1 gear ratio resulted in an 36% increased time (p=0.01) without a change in RPE (p =0.34).
  • Phase III (retention): Showed that the reduction in shoulder pain continued during the four weeks, the trend was for an increase in shoulder pain, returning towards the initial baseline.
  • These findings indicate the potential for shoulder pain reduction due to reduced joint loading with the use of MAGICWHEELS 2-speed wheels during daily mobility.

 

REFERENCES:

1. Finley, MA, et. al JRRD 2004; 41(3b): 395-402

2. Curtis, K.J. et. al JOSPT 1999; 29(4): 225-31

3. Curtis, KA, et. al Paraplegia 1995; 33(5): 290-3

4. Stanley, RK, et. al JRRD 2003; 40(4): 301-308