Objective To examine intra-individual variability of kinetic and temporal-spatial parameters of wheelchair propulsion as a function of shoulder pain in manual wheelchair users (MWUs). Design Cohort. Setting University research laboratory. Participants Adults with physical disabilities (N=26) who use a manual wheelchair for mobility full time (>80% ambulation). Interventions Participants propelled their own wheelchairs with force-sensing wheels at a steady-state pace on a dynamometer at 3 speeds (self-selected, 0.7m/s, 1.1m/s) for 3 minutes. Temporal-spatial and kinetic data were recorded unilaterally at the hand rim. Main Outcome Measures Shoulder pain was quantified with the Wheelchair Users Shoulder Pain Index. Intra-individual mean, SD, and coefficient of variation (CV=mean/SD) with kinetic and temporal-spatial metrics were determined at the handrim. Results There were no differences in mean kinetic and temporal-spatial metrics as a function of pain group (P values >.016). However, individuals with pain displayed less relative variability (CV) in peak resultant force and push time than pain-free individuals (P<.016). Conclusions Shoulder pain had no influence on mean kinetic and temporal-spatial propulsion variables at the handrim; however, group differences were found in relative variability. These results suggest that intra-individual variability analysis is sensitive to pain. We propose that variability analysis may offer an approach for earlier identification of MWUs at risk for developing shoulder pain.

Original languageEnglish (US)
Pages (from-to)699-704
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Issue number4
StatePublished - Apr 2014


  • Rehabilitation
  • Shoulder
  • Wheelchairs

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation


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