Biomechanics of adapted rowing in manual wheelchair users

Elizabeth Euiler

doi:10.17918/00001419

Individuals who use a manual wheelchair are at a high risk of developing long-term shoulder pain and impairment caused by increased demand and load on the shoulder during normal activities of daily living. Two main contributors to shoulder pain are overuse and shoulder muscle imbalance. Rehabilitation programs targeting shoulder pain suggest stretching anterior shoulder muscles and strengthening posterior shoulder muscles to promote balance and stability across the shoulder. Rowing-type exercises have been shown to successfully target the posterior muscles of the shoulder with evidence of decreased pain and increased shoulder strength after the completion of a functional electrical stimulation rowing intervention. In addition to reducing shoulder pain, it is crucial to identify methods and modes of exercise which are more widely accessible. Participation in physical activity provides physical, psychological, and social benefits. However, several barriers to physical activity have been reported in this population. Less than half of individuals with physical disabilities meet the American College of Sports Medicine's physical activity guidelines. The primary aim of this study was to analyze the biomechanics, as measured by scapulohumeral kinematics and muscle activation, and symmetry of the rowing stroke in an adapted setup in individuals who use a manual wheelchair for mobility. Muscle activity (electromyography) of four shoulder muscles (upper trapezius, lower trapezius, serratus anterior, and posterior deltoid) and 3D motion analysis of the humerus, scapula, and trunk were analyzed across three rowing conditions (adapted rowing ergometer, rowing ergometer from chair, standard row exercise) and between sides. We hypothesized that both adapted rowing ergometer conditions would lead to greater muscle activity than the standard rowing exercise and there would be no difference in humerus, scapula, or trunk kinematics among rowing conditions. It was also hypothesized that we would see symmetry across both muscle activity and kinematic measures. Upper extremity kinematics were symmetrical across rowing conditions with activity occurring below 90° of humeral elevation. Greater shoulder extension was seen at the finish position for the standard row exercise compared to the two ergometer rowing conditions. Overall, all three rowing conditions showed submaximal activation of the targeted muscles including increased lower trapezius activity without producing excessive upper trapezius activity. Findings from this study indicate that rowing is a highly repetitive low load activity occurring below 90° of humeral elevation. This suggests that rowing and rowing type activities have the potential to be an accessible form of exercise that facilitates increased shoulder strength and decreased should pain in individuals who use a manual wheelchair for mobility.

Biomechanics of adapted rowing in manual wheelchair users

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Biomechanics of adapted rowing in manual wheelchair users

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