{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:25:08Z","timestamp":1775129108884,"version":"3.50.1"},"reference-count":59,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T00:00:00Z","timestamp":1619136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["1R01HD084423-01"],"award-info":[{"award-number":["1R01HD084423-01"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002377"],"award-info":[{"award-number":["UL1 TR002377"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Shoulder pain and pathology are extremely common for individuals with spinal cord injuries (SCI) who use manual wheelchairs (MWC). Although risky humeral kinematics have been measured during wheelchair-based activities performed in the lab, little is known about arm kinematics in the free-living environment. The purpose of this study was to measure the humeral elevation workspace throughout a typical day for individuals with SCI who use a MWC and matched able-bodied controls. Thirty-four individuals with SCI who use a MWC (42.7\u00b112.7 years of age, 28 males\/6 females, C6-L1) and 34 age-and sex-matched controls were enrolled. Participants wore three inertial measurement units (IMU) on their upper arms and torso for one to two days. Humeral elevation angles were estimated and the percentage of time individuals spent in five elevation bins (0\u201330\u00b0, 30\u201360\u00b0, 60\u201390\u00b0, 90\u2013120\u00b0, and 120\u2013180\u00b0) were calculated. For both arms, the SCI cohort spent a significantly lower percentage of the day in 0\u201330\u00b0 of humeral elevation (Dominant: SCI = 15.7\u00b112.6%, Control = 32.1\u00b115.6%, p&lt;0.0001; Non-Dominant: SCI = 21.9\u00b117.8%, Control = 34.3\u00b115.5%, p = 0.001) and a significantly higher percentage of time in elevations associated with tendon compression (30\u201360\u00b0 of humeral elevation, Dominant: SCI = 62.8\u00b114.4%, Control = 49.9.1\u00b113.0%, p&lt;0.0001; Non-Dominant: SCI = 58.8\u00b114.9%, Control = 48.3\u00b113.6%, p = 0.003) than controls. The increased percentage of time individuals with SCI spent in elevations associated with tendon compression may contribute to increased shoulder pathology. Characterizing the humeral elevation workspace utilized throughout a typical day may help in understanding the increased prevalence of shoulder pain and pathology in individuals with SCI who use MWCs.<\/jats:p>","DOI":"10.1371\/journal.pone.0248978","type":"journal-article","created":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T14:34:09Z","timestamp":1619188449000},"page":"e0248978","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Humeral elevation workspace during daily life of adults with spinal cord injury who use a manual wheelchair compared to age and sex matched able-bodied controls"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-1878","authenticated-orcid":true,"given":"Brianna M.","family":"Goodwin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen M.","family":"Cain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meegan G.","family":"Van Straaten","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Fortune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5379-1462","authenticated-orcid":true,"given":"Omid","family":"Jahanian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa M. B.","family":"Morrow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,4,23]]},"reference":[{"key":"pone.0248978.ref001","first-page":"35","article-title":"Repetitive Strain Injury Among Manual Wheelchair Users","volume":"9","author":"R. A. Cooper","year":"1998","journal-title":"Team Rehab Report"},{"key":"pone.0248978.ref002","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0003-9993(99)90285-X","article-title":"Shoulder pain in wheelchair users with tetraplegia and paraplegia","volume":"80","author":"K. A. Curtis","year":"1999","journal-title":"Archives of physical medicine and rehabilitation"},{"key":"pone.0248978.ref003","doi-asserted-by":"crossref","first-page":"277","DOI":"10.2340\/16501977-0173","article-title":"Shoulder pain in persons with thoracic spinal cord injury: prevalence and characteristics","volume":"40","author":"M. 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