Context

Extreme conditioning programs (ECPs), such as CrossFit^®, are a relatively new method of fitness with rapid growth in individuals with paraplegia. However, it is unknown if wheelchair users are at an additional risk of musculoskeletal injury during these exercises. Biomechanical characterization is necessary to determine the safety and efficacy of ECPs as an exercise modality for wheelchair users with paraplegia.

Objective

To characterize the three-dimensional (3-D) thorax and upper extremity joint kinematics of paraplegic wheelchair athletes during exercises commonly prescribed as part of ECPs.

Design

Observational study

Participants

Three male wheelchair athletes, average age of 37.1 ± 4.6 years, with spinal cord injury levels of T8, L2, and T10, with varying exercise experience.

Methods

3-D movement was acquired using motion capture during the performance of four exercises: battle ropes, sled pull, overhead press, and sledgehammer swing. A custom upper extremity inverse kinematics model was applied to compute 3-D joint angles.

Outcome Measures

3-D peak thorax, glenohumeral, elbow, and wrist joint angles and ranges of motion (ROM), Visual Analog Scale (VAS), and Borg Scale of Perceived Exertion.

Results

Large joint motions were required for the exercises, at times demanding extreme shoulder and/or wrist flexion and extension, abduction, and external rotation, which are concerning for injury risk in wheelchair users. Participants, however, were able to perform the exercises pain free.

Conclusion

These quantitative findings highlight that wheelchair athletes may be exposed to potentially injurious positions during common ECP exercises. These findings provide insight that may lead to improved clinical guidelines for prescription and training of exercise regimens, particularly involving ECPs, for wheelchair users.

中文翻译：

---

交叉训练中截瘫轮椅运动员的生物力学分析

语境

极限训练计划 (ECP)，例如 CrossFit ^®，是一种相对较新的健身方法，在截瘫患者中发展迅速。然而，尚不清楚轮椅使用者在这些练习中是否会面临肌肉骨骼损伤的额外风险。生物力学表征对于确定 ECP 作为截瘫轮椅使用者的一种锻炼方式的安全性和有效性是必要的。

客观的

表征截瘫轮椅运动员在通常作为 ECP 的一部分进行的锻炼中的三维 (3-D) 胸腔和上肢关节运动学。

设计

观察性研究

参加者

三名男性轮椅运动员，平均年龄37.1±4.6岁，脊髓损伤程度分别为T8、L2和T10，运动经历各不相同。

方法

3-D 运动是在进行四种练习时使用动作捕捉获得的：战绳、拉雪橇、高架推举和大锤摆动。应用自定义上肢逆运动学模型来计算 3-D 关节角度。

结果措施

3-D 峰顶胸廓、盂肱关节、肘关节和腕关节角度和运动范围 (ROM)、视觉模拟量表 (VAS) 和感知用力的 Borg 量表。

结果

练习需要大幅度的关节运动，有时需要极度的肩部和/或腕部屈曲和伸展、外展和外旋，这对轮椅使用者来说有受伤的风险。然而，参与者能够无痛地进行练习。

结论

这些定量研究结果强调轮椅运动员在常见的 ECP 练习中可能会暴露在潜在的伤害位置。这些发现提供的见解可能会导致改进临床指南的处方和运动方案的培训，特别是涉及轮椅使用者的 ECP。