Mechanical load on the upper extremity during wheelchair activities

Arch Phys Med Rehabil. 2005 Jun;86(6):1214-20. doi: 10.1016/j.apmr.2004.09.023.


Objective: To determine the net moments on the glenohumeral joint and elbow joint during wheelchair activities.

Design: Kinematics and external forces were measured during wheelchair activities of daily living (level propulsion, riding on a slope, weight-relief lifting, reaching, negotiating a curb) and processed in an inverse dynamics biomechanic model.

Setting: Biomechanics laboratory.

Participants: Five able-bodied subjects, 8 subjects with paraplegia, and 4 subjects with tetraplegia.

Interventions: Not applicable.

Main outcome measure: Net moments on the glenohumeral joint and elbow joint.

Results: Peak shoulder and elbow moments were significantly higher for negotiating a curb and weight-relief lifting than for reaching, level propulsion, and riding on a slope. Overall, the elbow extension moments were significantly lower for subjects with tetraplegia than for those with paraplegia.

Conclusions: The net moments during weight-relief lifting and negotiating a curb were high when compared with wheelchair propulsion tasks. Taking the effect of frequency and duration into account, these loads might imply a considerable risk for joint damage in the long term.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acceleration
  • Activities of Daily Living
  • Adult
  • Biomechanical Phenomena
  • Elbow Joint / physiology*
  • Humans
  • Male
  • Models, Biological
  • Paraplegia / physiopathology
  • Quadriplegia / physiopathology
  • Shoulder Joint / physiology*
  • Spinal Cord Injuries / physiopathology*
  • Weight-Bearing / physiology
  • Wheelchairs*