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Wheelchair pushing and turning: lumbar spine and shoulder loads and recommended limits.

Authors
  • 1, 2
  • 1, 2, 3
  • 1, 2, 3
  • 1 a Spine Research Institute - Biodynamics Laboratory , The Ohio State University , Columbus , OH , USA.
  • 2 b Department of Integrated Systems Engineering , The Ohio State University , Columbus , OH , USA.
  • 3 c Department of Orthopaedics , Wexner Medical Center, The Ohio State University , Columbus , OH , USA.
Type
Published Article
Journal
Ergonomics
1366-5847
Publication Date
Volume
60
Issue
12
Pages
1754–1765
Identifiers
DOI: 10.1080/00140139.2017.1344445
PMID: 28627334
Source
Medline
Keywords
License
Unknown

Abstract

The objective of this study was to determine how simulated manual wheelchair pushing influences biomechanical loading to the lumbar spine and shoulders. Sixty-two subjects performed simulated wheelchair pushing and turning in a laboratory. An electromyography-assisted biomechanical model was used to estimate spinal loads. Moments at the shoulder joint, external hand forces and net turning torque were also assessed. Multiple linear regression techniques were employed to develop biomechanically based wheelchair pushing guidelines relating resultant hand force or net torque to spinal load. Male subjects experienced significantly greater spinal loading (p < 0.01), and spine loads were also increased for wheelchair turning compared to straight wheelchair pushing (p < 0.001). Biomechanically determined maximum acceptable resultant hand forces were 17-18% lower than psychophysically determined limits. We conclude that manual wheelchair pushing and turning can pose biomechanical risk to the lumbar spine and shoulders. Psychophysically determined maximum acceptable push forces do not appear to be protective enough of this biomechanical risk. Practitioner Summary: This laboratory study investigated biomechanical risk to the low back and shoulders during simulated wheelchair pushing. Manual wheelchair pushing posed biomechanical risk to the lumbar spine (in compression and A/P shear) and to the shoulders. Biomechanically determined wheelchair pushing thresholds are presented and are more protective than the closest psychophysically determined equivalents.

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