Korean J Sports Med.  2018 Mar;36(1):24-33. 10.5763/kjsm.2018.36.1.24.

The Influence of Wheelchair Use of Individuals with Spinal Cord Injury on Upper Extremity Muscular Function and Cross-Sectional Area

• Lee GH
• Shin YA

• KMID: 2465226
• DOI: http://doi.org/10.5763/kjsm.2018.36.1.24

Abstract

PURPOSE
This study was to compare the upper extremity muscular function and cross-sectional area (CSA) between wheelchair users and a pedestrian group and to observe how the changes in the muscle CSA affected upper extremity muscle function.
METHODS
The study was conducted on 10 patients with spinal cord injury (SCI) who were divided into two groups based on whether they used wheelchairs (wheelchair using [WU] group and pedestrian [PS] group). The Mann-Whitney U-test was used to analyze the data and determine whether there were significant differences between the groups.
RESULTS
Muscle mass in the WU group was significantly lower than in the PS groups (p < 0.01), while body fat percentage in the WU group was significantly higher than in the PS group (p < 0.05). The peak torque of shoulder external and right internal rotation was higher in the WU group than in the PS group (p < 0.05). Wrist muscle function was not significantly different for either group. In addition, the CSA of the right wrist extensor carpi radialis longus and left extensor digitorum communis was higher in the WU group than in the PS group (p < 0.05).
CONCLUSION
Using a manual wheelchair may benefit upper extremity function by increasing CSA and muscle function in patients with SCI despite having a negative effect on body composition. However, there is an increased risk of injury with SCI associated with upper extremity overload; thus, an effective exercise protocol is needed to prevent muscle imbalance and injury.

Keyword

Cross-sectional area; Muscular function; Spinal cord injuries; Wheelchairs

MeSH Terms

Adipose Tissue
Body Composition
Humans
Shoulder
Spinal Cord Injuries*
Spinal Cord*
Torque
Upper Extremity*
Wheelchairs*
Wrist

Figure

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  Fig. 1. Measure of shoulder internal rotation and external rotation isokinetic strength.

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  Fig. 2. Measure of wrist flexion and extension isokinetic strength.

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  Fig. 3. Cross-sectional area of extensor digitorum communis (EDC) and extensor carpi radialis longus (ECRL). (A) Right (Rt) ECRL, (B) left (Lt) ECRL, (C) Rt EDC, (D) Lt EDC. Rt: right, Lt: left.

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  Fig. 4. Results of body composition. WU: wheelchair users with spinal cord injury, PS: pedestrian with spinal cord injury.

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  Fig. 5. Results of shoulder muscular function. WU: wheelchair users with spinal cord injury, PS: pedestrian with spinal cord injury, Rt: right, BW: body weight, Lt: left, IR: internal rotation, ER: external rotation.

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  Fig. 6. Results of wrist muscular function. WU: wheelchair users with spinal cord injury, PS: pedestrian with spinal cord injury, Rt: right, flex: flexion, BW: body weight, exten: extension, Lt: left.

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  Fig. 7. Results of cross-sectional area (CSA). WU: wheelchair users with spinal cord injury, PS: pedestrian with spinal cord injury, Rt: right, ECRL: extensor carpi radialis longus, EDC: extensor digitorum communis, Lt: left.

Reference

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