John D. Lloyd, PhD, CPE
Board Certified Ergonomist
32824 Michigan Avenue
San Antonio, Florida 33576
Tel: 813-624-8986
Email: DrJohnLloyd@Tampabay.RR.com
Preserving transfer independence among individuals with spinal cord injury
Abstract: For the first time, a generation of individuals with spinal cord injury (SCI) are approaching their elder years. Since SCI is most endemic to a younger population who are living longer lives, concerns exist about maintaining independence with activities of daily living (ADL) and functional mobility over a longer time frame. Upper extremity (UE) deterioration has a tremendously detrimental effect on the independence, quality of life, cardiovascular disease risk, and life expectancy of individuals following SCI. When individuals with SCI participate in mobility or transfer research investigations consideration should focus on factors including age-length of time since SCI, pain and related psychosocial factors, shoulder range of motion, transfer technique, wheelchair-human interface, muscular strength, exercise capacity, and physical stain of ADL, body mass and composition, and previous UE injuries. This review describes the risk factors associated with UE deterioration among individuals with SCI; summarizes the research conducted to date in this area; identifies gaps in existing research; and recommends future research directions for studying transfer safety among individuals with SCI. Few studies have addressed transfers among subjects with SCI, and no existing study has integrated kinematic, kinetic and electromyographic data or analyzed net joint moments. These data are needed to accurately evaluate UE joint stresses, muscular demands and the inter-relationship between trunk position and UE functional demands. Recent innovations in mathematical modeling and computer simulation methods provide researchers with analytical tools which can reinforce UE preservation intervention planning for individuals with SCI. Through advanced technology, comprehensive clinical evaluation, and experimental research, clinical interventions to help ameliorate UE pain and injuries can be developed.
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