Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 10, 2014
   Pages 1515 — 1524

Abstract — Wheelchair ergonomic hand drive mechanism use improves wrist mechanics associated with carpal tunnel syndrome

Lisa A. Zukowski, MA;1* Jaimie A. Roper, MS;1 Orit Shechtman, PhD, OTR/L;2 Dana M. Otzel, PhD;1,3 Patty W. Hovis, MSESS;1 Mark D. Tillman, PhD1,4

Departments of 1Applied Physiology and Kinesiology and 2Occupational Therapy, University of Florida, Gainesville, FL; 3Geriatric Research, Education, and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, FL; 4Department of Kinesiology and Health Promotion, Troy University, Troy, AL

Abstract — Among conventional manual wheelchair (CMW) users, 49% to 63% experience carpal tunnel syndrome (CTS) that is likely induced by large forces transmitted through the wrist and extreme wrist orientations. The ergonomic hand drive mechanism (EHDM) tested in this study has been shown to utilize a more neutral wrist orientation. This study evaluates the use of an EHDM in terms of wrist orientations that may predispose individuals to CTS. Eleven adult full-time CMW users with spinal cord injury participated. Motion data were captured as participants propelled across a flat surface, completing five trials in a CMW and five trials in the same CMW fitted with the EHDM. Average angular wrist orientations were compared between the two propulsion styles. Use of the EHDM resulted in reduced wrist extension and ulnar deviation. The shift to more neutral wrist orientations observed with EHDM use may reduce median nerve compression.

Key words: assistive technology, biomechanics, kinematics, median nerve, mobility, propulsion, quality of life, spinal cord injury, upper limb, wheelchair.


View HTML ¦ View PDF ¦ Contents Vol. 51, No.10

This article and any supplementary material should be cited as follows:
Zukowski LA, Roper JA, Shechtman O, Otzel DM, Hovis PW, Tillman MD. Wheelchair ergonomic hand drive mechanism use improves wrist mechanics associated with carpal tunnel syndrome. J Rehabil Res Dev. 2014;51(10):1515–24.
http://dx.doi.org/10.1682/JRRD.2013.09.0211
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