{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:51:36Z","timestamp":1747151496195,"version":"3.40.5"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,6,11]],"date-time":"2022-06-11T00:00:00Z","timestamp":1654905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009192","name":"Alberta Innovates","doi-asserted-by":"publisher","award":["iCORE Strategic Research Chair"],"award-info":[{"award-number":["iCORE Strategic Research Chair"]}],"id":[{"id":"10.13039\/501100009192","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000038","name":"Natural Sciences and Engineering Research Council of Canada","doi-asserted-by":"publisher","award":["Undergraduate Student Research Award"],"award-info":[{"award-number":["Undergraduate Student Research Award"]}],"id":[{"id":"10.13039\/501100000038","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Axillary crutches are commonly used in rehabilitation. Inappropriately fit crutches may result in upper limb pain or injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the effects of axillary crutch length on upper limb kinematics to better understand potential injury mechanisms. It was hypothesized that crutches that were longer or shorter than standard\u2010fit crutches would alter upper limb kinematics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Gait laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Fifteen healthy males with no prior crutch experience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants were fit with axillary crutches using standardized methods, as well as with crutches that were 5\u2009cm longer and 5\u2009cm shorter. Participants performed swing\u2010through gait (1.20\u2009\u00b1\u20090.07\u2009ms<jats:sup>\u22121<\/jats:sup>) with all crutch lengths in randomized order. Kinematics were recorded using an optical motion\u2010tracking system and joint angles for the scapula, shoulder, elbow, and wrist were computed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The effects of crutch length on joint range of motion (ROM) and joint angles at initial crutch contact were analyzed using multivariate analysis (Hotelling's T<jats:sup>2<\/jats:sup>; \u03b1\u00a0=\u00a0.025) and simultaneous confidence intervals (CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The long\u2010standard crutch fit comparison showed effects across all joints (ROM <jats:italic>p<\/jats:italic>\u00a0=\u00a0.009; initial contact <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Longer crutches resulted in greater scapular upward rotation (mean difference [95% CI] ROM: 1.0 [\u22120.2 to 2.2]; initial contact: \u22122.7 [\u22124.4, \u22121.1]) and shoulder abduction (ROM: 0.8 [\u22120.1 to 1.8]; initial contact: \u22121.9 [\u22124.1 to 0.3]). Crutch length also had effects across all joints for the short\u2010standard fit comparison (ROM <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004; initial contact <jats:italic>p<\/jats:italic>\u00a0=\u00a0.016). Shorter crutches resulted in greater scapula downward rotation (2.2 [\u22120.4 to 4.8]) and greater shoulder adduction (2.5 [\u22120.6 to 5.6]) at initial contact. Shorter crutches also reduced shoulder flexion\/extension ROM (\u22122.5 [\u22124.4 to \u22120.6]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Altered crutch length results in scapular and shoulder kinematic deviations that may present risk factors for upper limb injury with crutch\u2010walking. This may underline the importance of appropriate device fitting to reduce injury risk in crutch users.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12809","type":"journal-article","created":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T12:28:47Z","timestamp":1648470527000},"page":"570-578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The effect of axillary crutch length on upper limb kinematics during swing\u2010through gait"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6674-7981","authenticated-orcid":false,"given":"Gregor","family":"Kuntze","sequence":"first","affiliation":[{"name":"Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Russell","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaine","family":"Jivan","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janet Lenore","family":"Ronsky","sequence":"additional","affiliation":[{"name":"Schulich School of Engineering University of Calgary  Calgary Alberta Canada"},{"name":"McCaig Institute for Bone and Joint Health University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5297-6553","authenticated-orcid":false,"given":"Ranita Harpreet Kaur","family":"Manocha","sequence":"additional","affiliation":[{"name":"McCaig Institute for Bone and Joint Health University of Calgary  Calgary Alberta Canada"},{"name":"Division of Physical Medicine &amp; Rehabilitation University of Calgary  Calgary Alberta Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.04.023"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-013-2266-x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12514"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2010.05.004"},{"key":"e_1_2_8_6_1","first-page":"233","article-title":"Complications from using axillary crutches","volume":"3","author":"Clarkson H","year":"1990","journal-title":"Can J Rehabil"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2020-236219"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-201001000-00006"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/03093648609164506"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/71.4.294"},{"key":"e_1_2_8_11_1","first-page":"535","article-title":"Canes, crutches and walkers","volume":"43","author":"Joyce BM","year":"1991","journal-title":"Am Fam Physician"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.301.6759.1037"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.05.026"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100850"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0021\u20109290(01)00222\u20106"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2004.05.042"},{"key":"e_1_2_8_17_1","unstructured":"UrbaniakGC PlousS.Research randomizer (version 4.0).2013"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2005.10.007"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20543"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/17483100902980950"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23919"},{"key":"e_1_2_8_22_1","unstructured":"Trujillo\u2010OrtizA Hernandez\u2010WallsR.Hotelling T2: Hotelling T\u2010Squared testing procedures for multivariate tests. 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