Biomechanics of Adaptive Rowing in Active and Inactive Manual Wheelchair Users
Condition: Wheelchair; Water Sports; Upper Extremity; Biomechanics; Electromyography; Kinematics
Study type: Observational

Summary: 
      This research is being performed to characterize the rowing stroke in active and inactive
      individuals who use a manual wheelchair. The investigators will be looking at muscle activity
      of four shoulder muscles (upper trapezius, lower trapezius, serratus anterior, and posterior
      deltoid) and motion of the arms, shoulder blade, and trunk during rowing. This will be done
      for three rowing conditions (1: adapted rowing ergometer, 2: rowing ergometer from a chair,
      3: standard seated row exercise using an elastic band [TheraBand]). The investigators are
      also looking at shoulder strength, range of motion, quality of life, and community
      participation.
    

Detailed description: 
      Individuals who use a manual wheelchair (MWC) are at a high risk of developing long-term
      shoulder pain and impairment caused by increased demand and load on the shoulder during
      normal daily activities. Two main contributors to shoulder pain are overuse and shoulder
      muscle imbalance. Rehabilitation programs targeting shoulder pain suggest stretching anterior
      shoulder muscles and strengthening posterior shoulder muscles to promote balance and
      stability across the shoulder. Rowing-type exercises have been shown to be beneficial in
      accomplishing this. In addition to reducing shoulder pain, it is crucial to identify methods
      and modes of exercise which are more widely accessible. Participation in physical activity
      provides physical, psychological, and social benefits. However, several barriers to physical
      activity have been reported in this population. Less than half of individuals with physical
      disabilities meet the American College of Sports Medicine's physical activity guidelines.

      The primary aim of this study is to determine the biomechanics of the rowing stroke in active
      and inactive individuals who use a MWC for mobility. Muscle activity (electromyography) of
      four shoulder muscles (upper trapezius, lower trapezius, serratus anterior, and posterior
      deltoid) and 3D motion analysis of the arms, shoulder blade, and trunk will be analyzed
      across three rowing conditions (adapted rowing ergometer, rowing ergometer from chair,
      standard row exercise). The investigators hypothesize rowing on the adapted rowing ergometer
      will lead to greater muscle activity than the standard rowing exercise and there will be no
      difference in arm, shoulder blade, and trunk movement between rowing conditions. The
      secondary aim of this study is to assess shoulder range of motion, pectoralis minor muscle
      extensibility, quality of life, and community participation. The investigators hypothesize
      active individuals will have a greater range of motion and pectoralis minor muscle
      extensibility and report lower quality of life and community participation than inactive
      individuals. This study seeks to lay the groundwork of evidence to suggest participation in
      rowing as a viable option to reduce the frequency and intensity of shoulder pain and provide
      a more accessible form of physical activity. Additionally, the investigators hope to
      contribute further insight into clinical measures (shoulder strength, range of motion,
      pectoralis minor muscle extensibility), subjective quality of life, and community
      participation in this population.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        All participants will be recruited through personal contact, using flyers, newsletters,
        email communication, and social media. Participants will be recruited from the community in
        the Greater Philadelphia area through previously established connections at the
        Philadelphia Center for Adapted Sports (PCAS) and Magee Rehabilitation Network, as well as
        through social media platforms (Facebook, Instagram) and the Drexel University College of
        Nursing and Health Professions webpage.