Longitudinal Evaluation of Variability of Stroke Patterns and Shoulder Forces in Pediatric SCI Wheelchair Users

Authors

Kevin Schlidt, Medical College of Wisconsin
Brooke A. Slavens, Marquette UniversityFollow
Alyssa J. Schnorenberg, University of Wisconsin - MilwaukeeFollow
Lawrence C. Vogel, Shriners Hospitals for Children
Gerald F. Harris, Marquette UniversityFollow

Document Type

Article

Language

eng

Publication Date

12-2017

Publisher

Elsevier

Source Publication

Archives of Physical Medicine and Rehabilitation

Source ISSN

0003-9993

Abstract

Research Objectives

To investigate changes in propulsive stroke patterns, glenohumeral joint forces, and pain in pediatric manual wheelchair users with respect to age to better understand risk for injury and contribute to training and rehabilitation.

Design

Longitudinal, prospective.

Setting

Motion Analysis Lab at Shriners Hospitals for Children-Chicago.

Participants

Three pediatric manual wheelchair users with spinal cord injury (SCI). Mean subject age for the first and second visit: 14.8 years (2.5 years) and 16.3 years (2.7 years), respectively. Bony level of SCI ranged from sixth cervical to ninth thoracic vertebra.

Interventions

Not applicable.

Main Outcome Measures

Propulsive stroke patterns and glenohumeral joint forces.

Results

There was significant variation in the stroke patterns, both within and between visits for all subjects. Additionally, patterns not represented by any of the four adult classifications were observed [1]. Further variation was seen in GH joint forces, as determined by our pediatric biomechanical model [1]. The average superior GH joint forces and the average lateral joint forces, both correlated with shoulder pathology [2], increased between visits, changing from 6.79 %BW to 8.53 %BW and from 5.70 %BW to 7.71 %BW, respectively. All other GH forces did not follow similar trends among subjects. Also, subjects with similar weight, time since injury, SCI level, and age differed in their joint forces and stroke patterns. The average reported pain on the Visual Analog Scale (VAS) [3] decreased from 6.67 (9.42) to 3.33 (4.71); however, one subject reported no change in pain.

Conclusions

While limited by the population size, the increased joint forces and fluctuating stroke patterns demonstrate the variability between these pediatric users. The variation in joint forces potentially resulting from the varied stroke patterns may be important in preventing overuse injuries and pain.

Comments

Archives of Physical Medicine and Rehabilitation, Vol. 98, No. 12 (December 2017): e177-e178. DOI.

Recommended Citation

Schlidt, Kevin; Slavens, Brooke A.; Schnorenberg, Alyssa J.; Vogel, Lawrence C.; and Harris, Gerald F., "Longitudinal Evaluation of Variability of Stroke Patterns and Shoulder Forces in Pediatric SCI Wheelchair Users" (2017). Biomedical Engineering Faculty Research and Publications. 593.
https://epublications.marquette.edu/bioengin_fac/593