This article and any supplementary material should be cited as follows: Zukowski LA, Roper JA, Shechtman O, Otzel DM, Hovis PW, Tillman MD. Wheelchair

This article and any supplementary material should be cited as follows: Zukowski LA, Roper JA, Shechtman O, Otzel DM, Hovis PW, Tillman MD. Wheelchair ergonomic hand drive mechanism use improves wrist mechanics associated with carpal tunnel syndrome. J Rehabil Res Dev. 2014;51(10):1515–24. http://dx.doi.org/10.1682/JRRD.2013.09.0211

Slideshow ProjectDOI:10.1682/JRRD.2013.09.0211JSP

Wheelchair ergonomic hand drive mechanism use improves wrist

mechanics associated with carpal tunnel syndrome

Lisa A. Zukowski, MA; Jaimie A. Roper, MS; Orit Shechtman, PhD, OTR/L; Dana M. Otzel, PhD; Patty W. Hovis, MSESS;

Mark D. Tillman, PhD



• Aim– Evaluate use of ergonomic hand drive mechanism (EHDM)

in terms of wrist orientations that may predispose conventional manual wheelchair (CMW) users to carpal tunnel syndrome (CTS).

• Relevance– Among CMW users, 49%–63% experience CTS.

• Likely due to combination of large forces transmitted through wrist and extreme wrist orientations.

– EHDM in this study uses more neutral wrist orientation.



Method

• Participants:– 11 adult full-time CMW users with spinal cord injury.

• Procedure:– Motion capture data were collected as participants

propelled across flat surface.• 5 trials in CMW. • 5 trials in same CMW fitted with EHDM.

– Compared average angular wrist orientations between the 2 propulsion styles.



Results

• Use of EHDM resulted in reduced wrist extension and ulnar deviation compared with CMW use.



Conclusion

• Shift to more neutral wrist orientations observed with EHDM use may reduce median nerve compression.

Documents

This article and any supplementary material should be cited as follows: Zukowski LA, Roper JA, Shechtman O, Otzel DM, Hovis PW, Tillman MD. Wheelchair