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.