Up to 84% of manual wheelchair users (MWCU) with spinal cord injury experience shoulder pain, which is correlated with shoulder adductor weakness in this population. Modeling studies have shown weak shoulder adductors lead to compensations from the deltoid and rotator cuff muscles during propulsion, which may lead to altered propulsion mechanics. However, the role recovery phase hand pattern has in pain development is unclear, as each hand pattern is associated with unique mechanics and different levels of muscle demand. Previous research found no correlation between hand pattern and shoulder pain at self-selected speeds. However, fast propulsion may exacerbate poor mechanics caused by shoulder muscle weakness, which may reveal those at risk for pain development. The present study evaluated whether the hand pattern used during fast wheelchair propulsion is correlated with shoulder pain. We also assessed whether shoulder adductor strength was correlated with hand pattern. Fast propulsion data from two subsets of MWCU were analyzed at three time points (baseline, 18 months, 36 months). All participants were pain-free at baseline. Subset 1 compared individuals who remained pain-free to those who developed shoulder pain. Subset 2 compared individuals with chronic pain at follow-up to those whose pain resolved over time. The hand pattern used was not different between groups in either subset. However, more over-rim patterns were correlated with lower adductor strength in Subset 1. These results suggest that although the hand pattern used during fast propulsion is not correlated with shoulder pain, more over-rim hand patterns may indicate weaker shoulder adductors.

多达 84% 的脊髓损伤手动轮椅使用者 (MWCU) 经历过肩痛，这与该人群的肩内收肌无力有关。建模研究表明，较弱的肩部内收肌会导致三角肌和肩袖肌肉在推进过程中得到补偿，这可能会导致推进力学发生改变。然而，恢复阶段手型在疼痛发展中的作用尚不清楚，因为每种手型都与独特的力学和不同水平的肌肉需求相关。先前的研究发现，在自选速度下，手型和肩部疼痛之间没有相关性。然而，快速推进可能会加剧由肩部肌肉无力引起的不良力学，这可能会揭示那些有疼痛发展风险的人。本研究评估了轮椅快速推进过程中使用的手部模式是否与肩痛相关。我们还评估了肩内收肌力量是否与手型相关。在三个时间点（基线、18 个月、36 个月）分析了来自两个 MWCU 子集的快速推进数据。所有参与者在基线时都没有疼痛。子集 1 将保持无痛的个体与出现肩痛的个体进行比较。子集 2 将随访时患有慢性疼痛的个体与疼痛随时间消退的个体进行了比较。使用的手型在任一子集中的组之间没有不同。然而，在子集 1 中，更多的轮辋模式与较低的内收肌强度相关。这些结果表明，尽管在快速推进过程中使用的手部模式与肩部疼痛无关，但