Shoulder Pain Prevention Program for Manual Wheelchair Users With Paraplegia: A Randomized Clinical Trial.

To compare prevalence of shoulder pain (SP) onset over 3 years for individuals with paraplegia from spinal cord injury who participate in one of two shoulder pain prevention program (SPPP) formats with that of a similar population without intervention, and to compare exercise adherence between two SPPP formats. The randomized clinical trial (compared to historical controls) included a volunteer sample of 100 individuals without SP at study entry. Eighty-seven participants returned for assessments at 18 and 36 months after study entry.

Telehealth monitor to measure physical activity and pressure relief maneuver performance in wheelchair users.

This study demonstrated the feasibility of a device for monitoring pressure relief maneuvers and physical activity for wheelchair users. The device counts the number of wheel pushes based on wheelchair acceleration and measures pressure relief maneuvers using a seat sensor consisting of three force sensing resistors (FSRs). To establish the feasibility of the seat sensor for the detection of pressure relief maneuvers, 10 wheelchair users and 10 non-disabled controls completed a series of wheelchair depression raises, forward trunk leans, and lateral trunk leans.

Objective and Self-Reported Physical Activity Measures and Their Association With Depression and Satisfaction With Life in Persons With Spinal Cord Injury.

Objective: To identify associations between objective and self-reported measures of physical activity (PA) and relationships with depression and satisfaction with life (SWL) in persons with spinal cord injury (SCI).

Design: Retrospective, cross-sectional study of objectively measured wheelchair propulsion (WCP) from 2 studies in which an odometer was attached to participants' wheelchairs to record daily speed and distance. Self-reported data were collected in a separate study examining dyspnea, PA, mood, and SWL.

Body mass index changes over 3 years and effect of obesity on community mobility for persons with chronic spinal cord injury.

Objective: To identify the prevalence of obesity in persons with chronic spinal cord injury (SCI), determine change in body mass index (BMI) over time, and identify impact of obesity on community mobility.

Design: Prospective three year longitudinal study.

Setting: Outpatient clinic of rehabilitation center.

Relationship Between Hand Contact Angle and Shoulder Loading During Manual Wheelchair Propulsion by Individuals with Paraplegia.

Background: Shoulder loading during manual wheelchair propulsion (WCP) contributes to the development of shoulder pain in individuals with spinal cord injury (SCI).

Objective: To use regression analysis to investigate the relationships between the hand contact angle (location of the hand on the pushrim at initial contact and release during the push phase of the WCP cycle) with propulsion characteristics, pushrim forces, and shoulder kinetics during WCP in individuals with paraplegia.

Methods: Biomechanical data were collected from 222 individuals (198 men and 24 women) with paraplegia from SCI during WCP on a stationary ergometer at a self-selected speed.

Car Transfer and Wheelchair Loading Techniques in Independent Drivers with Paraplegia.

Car transfers and wheelchair (WC) loading are crucial for independent community participation in persons with complete paraplegia from spinal cord injury, but are complex, physically demanding, and known to provoke shoulder pain. This study aimed to describe techniques and factors influencing car transfer and WC loading for individuals with paraplegia driving their own vehicles and using their personal WCs. Sedans were the most common vehicle driven (59%).

Shoulder Strength and Physical Activity Predictors of Shoulder Pain in People With Paraplegia From Spinal Injury: Prospective Cohort Study.

Background: Shoulder joint pain is a frequent secondary complaint for people following spinal cord injury (SCI).

Objective: The purpose of this study was to determine predictors of shoulder joint pain in people with paraplegia.

Methods/design: A 3-year longitudinal study was conducted.

Impact of a stance phase microprocessor-controlled knee prosthesis on level walking in lower functioning individuals with a transfemoral amputation.

Background: For individuals with transfemoral amputation, walking with a prosthesis presents challenges to stability and increases the demand on the hip of the prosthetic limb. Increasing age or comorbidities magnify these challenges. Computerized prosthetic knee joints improve stability and efficiency of gait, but are seldom prescribed for less physically capable walkers who may benefit from them.

Impact of stance phase microprocessor-controlled knee prosthesis on ramp negotiation and community walking function in K2 level transfemoral amputees.

Background: Microprocessor controlled prosthetic knees (MPK) offer opportunities for improved walking stability and function, but some devices' swing phase features may exceed needs of users with invariable cadence. One MPK offers computerized control of only stance (C-Leg Compact).

Objective: To assess Medicare Functional Classification Level K2 walkers' ramp negotiation performance, function and balance while using a non-MPK (NMPK) compared to the C-Leg Compact.

Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial.

Background: Shoulder pain is a common problem after spinal cord injury (SCI), with negative effects on daily activities and quality of life (QOL).

Objective: The purpose of this study was to determine the effect of an exercise program and instruction to optimize performance of upper-extremity tasks on shoulder pain in people with paraplegia from SCI.

Methods: Design Eighty individuals with paraplegia from SCI and shoulder pain were randomly assigned to receive either an exercise/movement optimization intervention or an attention control intervention.

Effect of AFO design on walking after stroke: impact of ankle plantar flexion contracture.

This study was conducted to compare the effects of three ankle-foot orthosis (AFO) designs on walking after stroke and determine whether an ankle plantar flexion contracture impacts response to the AFOs. A total of 30 individuals, ranging from 6-215 months post-stroke, were tested in four conditions: shoes only (SH), dorsi-assist/dorsi-stop AFO (DA-DS), plantar stop/free dorsiflexion AFO (PS), and rigid AFO (Rigid). Kinematics, kinetics, and electromyographic (EMG) activity were recorded from the hemiparetic lower extremity while participants walked at a self-selected pace.

Impact of Gender on Shoulder Torque and Manual Wheelchair Usage for Individuals with Paraplegia: A Preliminary Report.

BACKGROUND: The prevalence of women with spinal cord injury is increasing, and their unique attributes merit attention, specifically, shoulder strength and community wheelchair propulsion. RESULTS: Shoulder torques were 62%-96% greater in men than women, average daily distance traveled was greater for men, and average speeds were similar. CONCLUSIONS: Community wheelchair propulsion speed was similar between men and women but men were significantly stronger, therefore daily mobility requires a higher relative effort for women's shoulder muscles.

Gait parameters associated with responsiveness to treadmill training with body-weight support after stroke: an exploratory study.

Background: Task-specific training programs after stroke improve walking function, but it is not clear which biomechanical parameters of gait are most associated with improved walking speed.

Objective: The purpose of this study was to identify gait parameters associated with improved walking speed after a locomotor training program that included body-weight-supported treadmill training (BWSTT).

Design: A prospective, between-subjects design was used.