Putting Pain Under the Microscope: Q&A with Melissa M. Morrow, Ph.D.

Self-propelling manual wheelchairs has long been anecdotally equated with shoulder pain. But is this assumed relationship true?

Melissa M. Morrow, Ph.D., with the Mayo Clinic in Rochester, Minn., recently won a $100,000 grant from Paralyzed Veterans of America to study that correlation, among others. Her project is entitled "Manual Wheelchair Activities Associated with Shoulder Pain and Injury." Mobility Management asked Morrow about her two-year grant.

Q: What are your main research goals?

Morrow: The research goals for the grant funded by the Paralyzed Veterans of America Research Foundation are to identify the key factors that contribute to shoulder pain and injury in the manual wheelchair population.

It is generally accepted that a majority of shoulder problems in this population are due to the repetitive nature of wheelchair propulsion causing overuse injuries, but this is not well documented. Most of the data we have on the activities performed by manual wheelchair users are from questionnaires and do not give an accurate account of the time spent propelling versus the time spent lifting and the associated loads. Hence, this research will fill in the gaps by quantifying the activities performed by manual wheelchair users.

Q: What are your strategies for examining this topic?

Morrow: We are recruiting experienced manual wheelchair users with and without current shoulder pain and gathering data on how they use their wheelchairs during their daily life. Each participant will wear special force sensors on gloves and motion sensors on their arms and torso during a day-long collection period. The force sensors will measure the load that goes through their hands during their activities of daily living, and the motion sensors will measure the posture of their arms and torso throughout the day.

With this information, we'll be able to determine how much of their day is spent performing different activities such as propelling, lifting, and sitting still; and we'll be able to quantify the magnitude of loading during the different activities. Additionally, we'll determine how much of the day is spent doing overhead activities which are known to be a risk factor for shoulder injuries. Based on the study population, we hope to highlight differences in daily activities between those with and without shoulder pain.

Q: How do you hope your work will be used in the future to improve the daily lives and activities of manual chair users?

Morrow: With this information, we can identify types of activities or types of loading that place a manual wheelchair user at an increased risk for shoulder pain and injury. This information can be used to aid in rehabilitation and prevention strategies to mitigate the risk of injury.

This article originally appeared in the SCI Handbook September 2011 issue of Mobility Management.

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