Three-Dimensional Biomechanics of the Trunk and Upper Extremity During Overhead Throwing in Wheelchair Lacrosse Athletes With Spinal Cord Injury.

OBJECTIVE: Quantify differences in overhead throwing kinematics between wheelchair lacrosse athletes with spinal cord injury and able-bodied lacrosse athletes. DESIGN: This is a cross-sectional, prospective study. Motion analysis captured overhead throwing motions of five wheelchair lacrosse athletes with spinal cord injury and six able-bodied lacrosse athletes seated in a wheelchair and standing. Three-dimensional thorax and dominant arm sternoclavicular, acromioclavicular, glenohumeral, elbow, and wrist joint angles, ranges of motion, as well as angular velocities were computed using an inverse kinematics model. Nonparametric tests assessed group differences ( P < 0.05). RESULTS: Participants with spinal cord injury exhibited less peak thorax axial rotation, ranges of motion, and angular velocity, as well as greater wrist flexion than able-bodied participants seated. Participants with spinal cord injury exhibited less peak thorax axial rotation and lateral bending, ranges of motion, and three-dimensional angular velocities; less peak two-dimensional sternoclavicular joint motion, ranges of motion, and peak angular velocities; less peak acromioclavicular joint protraction angular velocity; less glenohumeral joint adduction-abduction and internal-external rotation motion, ranges of motion, and angular velocities; and greater wrist flexion than able-bodied participants standing. CONCLUSIONS: Kinematic differences were observed between groups, with athletes with spinal cord injury exhibiting less thorax and upper extremity joint motion and slower joint angular velocities than able-bodied athletes. This knowledge may provide insights for movement patterns and potential injury risk in wheelchair lacrosse.

The Influence of Sex on Upper Extremity Joint Dynamics in Pediatric Manual Wheelchair Users With Spinal Cord Injury.

INTRODUCTION: Manual wheelchair propulsion is a physically demanding task associated with upper extremity pain and pathology. Shoulder pain is reported in over 25% of pediatric manual wheelchairs users, and this number rises over the lifespan. Upper extremity biomechanics in adults has been associated with shoulder pain and pathology; however, few studies have investigated upper extremity joint dynamics in children. Furthermore, sex may be a critical factor that is currently unexplored with regard to pediatric wheelchair mobility. OBJECTIVES: To investigate differences in upper extremity joint dynamics between pediatric male and female manual wheelchair users with spinal cord injury (SCI) during wheelchair propulsion. METHODS: Novel instrumented wheelchair hand-rims synchronized with optical motion capture were used to acquire upper extremity joint dynamics of 20 pediatric manual wheelchair users with SCI (11 males, 9 females). Thorax, sternoclavicular, acromioclavicular, glenohumeral, elbow, and wrist joint kinematics and kinetics were calculated during wheelchair propulsion. Linear mixed models were used to assess differences between sexes. RESULTS: Females exhibited significantly greater peak forearm pronation (p = .007), normalized wrist lateral force (p = .03), and normalized elbow posterior force (p = .04) than males. Males exhibited significantly greater peak sternoclavicular joint retraction (p < .001) than females. No significant differences between males and females were observed for the glenohumeral joint (p > .012). CONCLUSION: This study found significant differences in upper extremity joint dynamics between sexes during manual wheelchair propulsion. Our results underscore the importance of considering sex when evaluating pediatric wheelchair mobility and developing comprehensive wheelchair training interventions for early detection and prevention of upper extremity pain and pathology.

BIOMECHANICAL INFLUENCES OF A POSTURAL COMPRESSION GARMENT ON SCAPULAR POSITIONING.

BACKGROUND: The scapula is a critical link utilized in the kinetic chain to achieve efficient overhead movement and transfer energy from the lower extremity to the upper extremity. Additionally, daily activities such as sitting at a computer or driving in a car may negatively influence an individual's ability to maintain proper body posture and therefore compromise those movements. To reduce these negative influences, posture garments have been designed to cue the individual in maintaining and improving posture and alignment, specifically targeting scapular positioning. PURPOSE: The purpose of this study was to compare scapular positioning between an IntelliSkin™ posture-cueing compression garment and a generic performance garment on scapular kinematics during static standing.Study Design: Case control. METHODS: Forty active females (1.68 ± 0.07 m; 67.29 ± 11.25 kg) stood in a natural standing position while wearing two different garments: IntelliSkin™ posture-cueing compression garment and a generic performance garment. Kinematic data were collected at 100 Hz using an electromagnetic tracking system (trakSTAR™, Ascension Technologies, Inc., Burlington, VT, USA) synced with The MotionMonitor® (Innovative Sports Training, Chicago, IL., USA). RESULTS: Repeated measures ANOVAs revealed a statistically significant Shirt by Side interaction for scapular protraction/retraction (F(1,39) = 52.91, p ≤ 0.05) and main-effect of Shirt for scapula anterior/posterior tilt (F(1,39) = 96.45, p ≤ 0.05). Individuals showed increased retraction and posterior tilt while wearing the IntelliSkin™ posture-cueing compression garment. CONCLUSION: The results of the current study indicate that the IntelliSkin™ posture-cueing compression garment improved scapular positioning during static standing posture. The IntelliSkin™ posture-cueing compression garment may provide clinicians an adjunct strategy to include with rehabilitative protocols. LEVEL OF EVIDENCE: Diagnosis, Level 3.

Neck Kinematics and Electromyography While Wearing Head Supported Mass During Running.

BACKGROUND: Advanced combat helmets (ACH) coupled with night-vision goggles (NVG) are required for tactical athletes during training and service. Head and neck injuries due to head supported mass (HSM) are a common occurrence in military personnel. The current study aimed to investigate the effects of HSM on neck muscle fatigue that may lead to chronic stress and injury of the head and neck. METHODS: Subjects wore an ACH and were affixed with electromagnetic sensors to obtain kinematic data, as well as EMG electrodes to obtain muscle activations of bilateral sternocleidomastoid, upper trapezius, and paraspinal muscles while running on a treadmill. Subjects performed a 2-min warmup at a walking pace, a 5-min warmup jog, running at a pace equal to 90% maximum heart rate until absolute fatigue, and lastly a 2-min cooldown at a walking pace. Kinematic and EMG data were collected over each 2-min interval. Days later, the same subjects wore the same ACH in addition to the NVG and performed the same protocol as the first session. RESULTS: This study showed significant differences in muscle activation of the right upper trapezius [F(1,31) = 10.100] and both sternocleidomastoid [F(1,31) = 12.280] muscles from pre-fatigue to absolute fatigue. There were no significant differences noted in the kinematic variables. DISCUSSION: This study suggests that HSM can fatigue bilateral neck flexors and rotators, as well as fatigue the neck extensors and rotators on the contralateral side of the mounted NVG.Hanks MM, Sefton JM, Oliver GD. Neck kinematics and electromyography while wearing head supported mass during running. Aerosp Med Hum Perform. 2018; 89(1):9-13.