Journal of Rehabilitation Research & Development (JRRD)

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Volume 50 Number 6, 2013
   Pages 861 — 874

Abstract — How "healthy" is circuit resistance training following paraplegia? Kinematic analysis associated with shoulder mechanical impingement risk

Linda M. Riek, DPT, PhD;1* Paula M. Ludewig, PT, PhD;2 Deborah A. Nawoczenski, PT, PhD3

1Department of Physical Therapy, Nazareth College, Rochester, NY; 2Department of Physical Medicine and Rehabilitation, Program in Physical Therapy, University of Minnesota, Minneapolis, MN; 3Department of Physical Therapy, Ithaca College, Rochester, NY

Abstract — The purpose of the study was to determine whether wheelchair-based circuit resistance training (CRT) exercises place the shoulder at risk for mechanical impingement. Using a novel approach, we created a mechanical impingement risk score for each exercise by combining scapular and glenohumeral kinematic and exposure data. In a case series design, 18 individuals (25–76 yr old) with paraplegia and without substantial shoulder pain participated. The mean mechanical impingement risk scores at 45–60 degrees humerothoracic elevation were rank-ordered from lowest to highest risk as per subacromial mechanical impingement risk: overhead press (0.6 +/– 0.5 points), lat pulldown (1.2 +/– 0.5 points), chest press (2.4 +/– 2.8 points), row (2.7 +/– 1.6 points), and rickshaw (3.4 +/– 2.3 points). The mean mechanical impingement risk scores at 105–120 degrees humerothoracic elevation were rank-ordered from lowest to highest risk as per internal mechanical impingement risk: lat pulldown (1.2 +/– 0.5 points) and overhead press (1.3 +/– 0.5 points). In conclusion, mechanical impingement risk scores provided a mechanism to capture risk associated with CRT. The rickshaw had the highest subacromial mechanical risk, whereas the overhead press and lat pulldown had the highest internal mechanical impingement risk. The rickshaw was highlighted as the most concerning exercise because it had the greatest combination of magnitude and exposure corresponding with increased subacromial mechanical impingement risk.

Key words: biomechanics, circuit resistance training, conditioning, exercise, impingement, kinematics, paraplegia, shoulder, spinal cord injury, wheelchair.


View HTML  ¦  View PDF  ¦  Contents Vol. 50, No. 6
This article and any supplementary material should be cited as follows:
Riek LM, Ludewig PM, Nawoczenski DA. How "healthy" is circuit resistance training following paraplegia? A kine
matic analysis associated with shoulder mechanical impingement risk. J Rehabil Res Dev. 2013; 50(6):861–74.
http://dx.doi.org/10.1682/JRRD.2012.06.0112
ResearcherID/ORCID: Linda M. Riek, DPT, PhD: G-5302-2013; Paula M. Ludewig, PT, PhD: G-5418-2013; Deborah A. Nawoczenski, PT, PhD: G-5340-2013
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Last Reviewed or Updated  Tuesday, September 10, 2013 10:17 AM

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