A woman using exerstrider

One of the many hats I wear is directing the Rehabilitation Engineering Research Center on Recreational Technologies and Exercise Physiology Benefiting Persons with Disabilities. RecTech's primary focus is to enhance universal design features of equipment, programs, and facilities by encouraging engineers, researchers, exercise physiologists, entrepreneurs, industry professionals, and people with disabilities to work collaboratively to research, develop, demonstrate, evaluate, and adopt new approaches to increasing access to and participation in exercise and recreational activities among people with disabilities.

One of the major goals of RecTech is to find innovative exercise technologies that can reduce shoulder pain in manual wheelchair users. Research has shown that physical performance and quality of life can be adversely affected by upper-limb pain resulting from repetitive stress injuries in manual wheelchair users. Muscle imbalances around the shoulder joint are thought to contribute to this pain and increase the likelihood of shoulder injuries. Increased vertical forces at the shoulder joint, coupled with reduced shoulder depressor strength, may contribute to shoulder problems in manual wheelchair users. Over time, independently propelling a manual wheelchair and performing transfers frequently result in repetitive motion injuries at the shoulder, elbow, or wrist.

During one of our annual advisory panel meetings a couple of years ago, one of our members who invented a set of walking poles brought a set to the meeting and asked another member who uses a wheelchair to try them out. Through this relationship with our Center, Tom Rutlin, President of Exerstrider, Inc., began to evaluate whether the upper-body workout derived from PoleStriding could also be obtained from PoleWheeling, which involved using his specially- designed walking poles to propel a manual wheelchair. As can be seen in the photo, the PoleWheeling motion is a great alternative to the standard propulsion of a wheelchair, which involves a large percentage of the anterior shoulder joint musculature but neglects the back musculature, which is often weaker in persons who use wheelchairs. In order to counterbalance the forces displaced on the shoulder joint, a great alternative for manual wheelchair users is to avoid overusing their anterior muscle groups by using Tom's walking poles to ambulate their chairs using their back musculature. The poles require the individual to use the shoulder and elbow extensors and the shoulder girdle depressors, which are all important muscle groups to strengthen. These muscle groups are rarely used by manual wheelchair users and the PoleWheeling movement can provide an excellent workout while protecting the chest and anterior shoulder musculature from overuse.

Individuals who use manual wheelchairs rely on their upper bodies for ambulation and for performing various instrumental activities of daily living (ADL) such as transfers and wheeling up and down ramps and sidewalks or over difficult surfaces such as carpeting. As a result of using these smaller muscle groups to perform many activities during the day, an overuse injury can occur and could have a dramatic impact on the individual's quality of life. It seems like a good idea for wheelchair users to pack these portable lightweight walking/wheeling poles with them when they head outdoors, so that they can occasionally switch over from a forward propelling motion to one that uses more of the back musculature. Shoulder pain is a major secondary condition experienced by manual wheelchair users and PoleWheeling may be an excellent way to reduce shoulder pain.