Effect of 2-speed geared manual wheelchair propulsion on shoulder pain and function.

Abstract

To investigate the impact of a manual 2-gear drive wheelchair wheel (MAGICWheels) on shoulder pain and function in manual wheelchair users. A single-group, repeated-measures pre- and postdesign with baseline and retention. General community. Full-time manual wheelchair users (N=17) currently experiencing shoulder pain (mean age, 46+/-14 y; wheelchair use, 15+/-10 y). Five-month trial using a 2-gear wheelchair wheel. The Wheelchair Users Shoulder Pain Index (WUSPI), Wheelchair Users Functional Assessment (WUFA), and timed hill climb test with rating of perceived exertion (RPE). There was significant reduction in shoulder pain after the intervention at week 2 (P=.004) through week 16 (P=.015). The difference was not found at week 20; however, 1 participant reported an increase in pain from unrelated factors during week 20. Change from baseline was calculated without this subject's data; there was a significant reduction in shoulder pain (P=.003). There was no difference in WUFA after using the 2-gear wheel (P=.06). Hill climb time was longer when using the 2-gear wheel (P=.01), but no difference in the RPE (P=.13) resulted. Shoulder pain during the 4-week retention phase showed a trend toward increasing, as indicated by increased WUSPI scores. There was not a significant percentage increase, however, in comparison with the final week of using the MAGICWheels (P<.05). There were pain reductions 2 weeks after using the MAGICWheels, indicating a rapid response to the intervention. These findings indicate the potential for shoulder pain reduction with the use of a manual drive wheel during mobility, even in highly functional manual wheelchair users.