Lesiones músculo-esqueléticas de hombro en usuarios de silla de ruedas / Musculo-skeletal injuries of shoulder in wheelchair users

Manual wheelchair is one the most used mobility device in people that is unable to walk. It enhances functional independence in non ambulant people, but it costs a great energy expenditure and is a source of painful musculoskeletal injuries. The most frequently affected joint in manual wheelchair users is the shoulder (rotator cuff tendinopathy and subacromial impingement). In this review, we aim to describe the risk factors and biomechanical issues that make wheelchair users more prone to develop shoulder pain. Further, we discuss potencial approaches for the prevention and early treatment of these injuries. (AU)

Fatores associados ao uso de cadeira de rodas por idosos institucionalizados / Factors associated with the use of wheelchairs by institutionalized elderly people

Resumo Devido à alta prevalência do uso de cadeira de rodas por idosos institucionalizados, objetivou-se verificar se os fatores sexo, idade, escolaridade, tempo de admissão, comorbidades, cognição e funcionalidade estão associados ao uso deste dispositivo, como também averiguar os motivos que podem levar a essa utilização segundo a percepção dos idosos. Estudo transversal e descritivo, incluídos 55 idosos subdivididos em G1 (locomoção sem auxílio) e G2 (cadeirantes). Análise do perfil através dos prontuários, cognição e funcionalidade pelo Mini-Exame do Estado Mental e Índice de Barthel. Foram questionados 33(60,0%) cadeirantes no G1 e 22(40,0%) no G2 sobre os fatores que os levaram à utilização da cadeira de rodas. Houve diferença entre os grupos em relação à funcionalidade (p = 0,005). O idoso que não tem acidente vascular encefálico tem menor chance de utilizar cadeira de rodas (OR:0,09; IC95%:0,02-0,36). Idosos cadeirantes relataram: medo de cair, dor, cansaço, fraqueza nas pernas, dificuldades de caminhar e falta de auxílio na deambulação. O acidente vascular encefálico e a funcionalidade estão associados ao uso de cadeira de rodas. O conhecimento destes fatores e dos motivos relatados pelos idosos pode permitir que alternativas de prevenção sejam traçadas.

Abstract Due to the high prevalence of wheel-chair use by institutionalized elderly people, the scope of this research was to verify whether factors involving gender, age, education, length of institutionalization, comorbidities, cognition and functionality are associated with the use of such equipment, as well as ascertain the reasons for use according to the perceptions of the elderly. It is a cross-sectional descriptive study that included 55 elderly people subdivided into G1 (locomotion without assistance) and G2 (wheelchair users). Analysis of the profile in medical records, cognition and functionality by the Mini-Mental State Examination and Barthel index was conducted. Wheelchair users asked about the factors that lead to wheelchair use were recorded: 33 (60%) of the elderly were in G1 and 22 (40%) in G2. There were differences between the groups with respect to functionality (p = 0.005). The elderly who have not suffered a stroke are less likely to use a wheelchair (OR: 0.09; 95% CI: 0.02 to 0.36). Elderly wheelchair users reported: fear of falling, pain, tiredness, weakness in the legs, difficulty walking and lack of assistance in walking. Strokes and functionality are associated with wheelchair use. Knowledge of these factors and the reasons reported by the elderly may enable alternatives of prevention to be defined.

Respiratory muscle strength and aerobic performance of wheelchair basketball players

The respiratory system has been described as a limiting factor in the performance of athletes. Therefore, the objective of this study was to evaluate the relationship between the respiratory muscle strength (RMS) and aerobic performance of wheelchair basketball players (WCBPs). We evaluated 19 male WCBPs who were divided into two groups: trunk control group (TCG) and without trunk control group (WTCG). All participants underwent a pulmonary function test, evaluation of maximal inspiratory (MIP) and expiratory (MEP) pressures, and an aerobic performance test. The MIP of both groups and the MEP values of TCG exceeded the predicted values for age and gender. No differences were observed in the MIP and aerobic performance between the groups although a difference was observed in the MEP values. Positive correlations were observed between MIP/MEP and the aerobic performance for both groups. These results suggested that the overall RMS of this group of WCBPs fell within or above the predicted values. Hence, the study concluded that RMS can positively influence the aerobic performance of WCBP

Exploring the impact of wheelchair design on user function in a rural South African setting

Background: Wheelchairs provide mobility that can enhance function and community integration. Function in a wheelchair is influenced by wheelchair design. Objectives: To explore the impact of wheelchair design on user function and the variables that guided wheelchair prescription in the study setting. Method: A mixed-method, descriptive design using convenience sampling was implemented. Quantitative data were collected from 30 wheelchair users using the functioning every day with a Wheelchair Scale and a Wheelchair Specification Checklist. Qualitative data were collected from ten therapists who prescribed wheelchairs to these users, through interviews. The Kruskal-Wallis test was used to identify relationships; and content analysis was undertaken to identify emerging themes in qualitative data. Results: Wheelchairs with urban designs were issued to 25 (83%) participants. Wheelchair size; fit, support and functional features created challenges concerning transport, operating the wheelchair, performing personal tasks, and indoor and outdoor mobility. Users using wheelchairs designed for use in semi-rural environments achieved significantly better scores regarding the appropriateness of the prescribed wheelchair than those using wheelchairs designed for urban use (p = 0.01). Therapists prescribed the basic, four-wheel folding frame design most often because of a lack of funding, lack of assessment, lack of skills and user choice. Conclusion: Issuing urban type wheelchairs to users living in rural settings might have a negative effect on users' functional outcomes. Comprehensive assessments, further training and research, on long term cost and quality of life implications, regarding provision of a suitable wheelchair versus a cheaper less suitable option is recommended

Programa de kinesiología deportiva / Program of sport kinesiology

Este trabajo muestra un modelo de tratamiento kinesiológico con jóvenes portadores de discapacidad del aparato locomotor a través de un programa de kinesiología deportiva. Sumariamente exhibe el trabajo de más de 10 años con fundamentos, objetivos y resultados