Background Manual wheelchair users report a high prevalence of shoulder pain. Growing evidence shows that variability in forces applied to biological tissue is related to musculoskeletal pain. The purpose of this study was to examine the variability of forces acting on the shoulder during wheelchair propulsion as a function of shoulder pain. Methods Twenty-four manual wheelchair users (13 with pain, 11 without pain) participated in the investigation. Kinetic and kinematic data of wheelchair propulsion were recorded for 3 min maintaining a constant speed at three distinct propulsion speeds (fast speed of 1.1 m/s, a self-selected speed, and a slow speed of 0.7 m/s). Peak resultant shoulder forces in the push phase were calculated using inverse dynamics. Within individual variability was quantified as the coefficient of variation of cycle to cycle peak resultant forces. Findings There was no difference in mean peak shoulder resultant force between groups. The pain group had significantly smaller variability of peak resultant force than the no pain group (P < 0.01, η2 = 0.18). Interpretation The observations raise the possibility that propulsion variability could be a novel marker of upper limb pain in manual wheelchair users.

Original languageEnglish (US)
Pages (from-to)967-972
Number of pages6
JournalClinical Biomechanics
Issue number9-10
StatePublished - Nov 2013


  • Inverse dynamics
  • Joint kinetics
  • Movement variability
  • Pain
  • Shoulder

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Biophysics


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