Using a manual wheelchair can lead to shoulder pain. Researchers want to change that.

VCU’s Carrie Peterson is part of a national team seeking to improve health for patients with spinal cord injury.

A person seated in a wheelchair grapples a wheel.
84 percent of patients who use manual wheelchairs develop shoulder pain associated with overuse injuries. (Getty Images)

Individuals with spinal cord injury and resulting lower limb paralysis can retain some independence by using manual wheelchairs, but up to 84 percent of patients who use them develop shoulder pain associated with overuse injuries.

Researchers have discovered a difference between individuals with spinal cord injuries who began using manual wheelchairs as children and those injured as adults. Despite more years of wheelchair use, adults with pediatric onset actually have less shoulder pain, said Carrie Peterson, Ph.D., an assistant professor in the Department of Biomedical Engineering in VCU’s College of Engineering.

Carrie Peterson, Ph.D.
Carrie Peterson, Ph.D., is researching how to improve health and quality of life for individuals with spinal cord injury who use manual wheelchairs. (Photo courtesy VCU College of Engineering)

“The benefit of a manual wheelchair is that it continues to give that person some degree of exercise,” Peterson said. “Ideally, we can develop strategies to keep people using manual wheelchairs in a manner that doesn’t create shoulder pain.”

Peterson is researching how to improve health and quality of life for individuals with spinal cord injury who use manual wheelchairs — from childhood through adulthood. She is part of a team led by researchers at the University of Wisconsin-Milwaukee that has received a $2.5 million grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health. The four-year study is aimed at disease prevention for individuals with spinal cord injury through the use of advanced biomechanical modeling and diagnostic imaging.

Peterson, who will receive $413,544 under the grant, will generate computational simulations of musculoskeletal dynamics during wheelchair propulsion to quantify shoulder joint contact forces.

“The goal of the project is to determine whether the movement variability reduces the shoulder joint demands, and therefore leads to decreased shoulder pain and progressive pathology,” she said.

The long-term goal is to develop rehabilitation strategies to prevent and treat symptoms of shoulder loading and overuse contributing to shoulder pain by creating guidelines for children and improving those for adults 

The problem with the secondary medical condition of shoulder pain is critical for individuals with spinal cord injury, Peterson said, “because pain leads to the loss of their ability to use their arms — which they rely on for mobility and independence.”

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