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The impact of wheelchair type on reducing the risk of shoulder overuse injuries following spinal cord injury

Rose, LS; (2012) The impact of wheelchair type on reducing the risk of shoulder overuse injuries following spinal cord injury. Masters thesis , UCL (University College London). Green open access

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Abstract

With the extensive support of the UK spinal cord injuries centres (SCIC) two surveys were conducted to evaluate changes in wheelchair provision to people with spinal cord injury (SCI) before and after the introduction of the Wheelchair Voucher Scheme in 1997. The surveys covered the periods 1991-1997 and 1998-2004. Of the 526 manual wheelchair users recruited from the eight SCICs in England for the 1991-1997 survey, 52% abandoned their initial wheelchair within one year of discharge. The main reason for changing the wheelchair was ‘pushability’, i.e. the effort involved in propulsion. As there is a period of adaptation and consolidation of skills following discharge back into the community, a pilot biomechanical study was designed to investigate further whether this change of wheelchair was triggered by changes in the propulsion biomechanics over time or due to other changes in the participants. The pilot study examined a cohort of 19 newly injured people at time of discharge, 13 of whom were retested at six months post-discharge. There is a growing body of evidence linking the use of a manual wheelchair to secondary upper limb problems. No previous studies have analysed the severity of shoulder pain and associated it with the types of wheelchairs used. The participants in the wheelchair provision survey were invited to complete the Wheelchair User’s Shoulder Pain Index (WUSPI) to evaluate the size of the problem in this population and relate it to their specific wheelchair use. This study group comprised 705 full-time manual wheelchair users, recruited from 10 SCICs throughout the UK. The comparison of the 1991-97 and 1998-2004 surveys showed that wheelchair provision has changed towards the lighter and more customizable wheelchair. Some significant changes in propulsion biomechanics were found between the results at discharge and six months. The shoulder pain analysis revealed that pain was reported to be more severe in individuals using folding frame manual wheelchairs.

Type: Thesis (Masters)
Title: The impact of wheelchair type on reducing the risk of shoulder overuse injuries following spinal cord injury
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright restricted material has been removed from the e-thesis
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
URI: https://discovery.ucl.ac.uk/id/eprint/1358180
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