Ursina Arnet, Stefan van Drongelen, Anke Scheel-Sailer, Lucas H.V. van der Woude, Dirkjan H.E.J. Veeger
DOI: 10.2340/16501977-0929

Objective: To compare the shoulder load during handcycling and wheelchair propulsion under similar conditions of external power in persons with spinal cord injury.
Design: Cross-sectional.
Subjects: Eight men with spinal cord injury.
Methods: Kinetics and kinematics were measured during handbike and wheelchair propulsion at 25, 35, 45 and 55 W on a treadmill. Shoulder load (glenohumeral contact forces, relative muscle forces) was calculated with the Delft Shoulder and Elbow Model.
Results: At all power output levels, glenohumeral contact forces were significantly lower during handcycling compared with wheelchair propulsion (p < 0. 001). At 55 W, the mean glenohumeral contact force was 345 N for hand­cycling, whereas it was 585 N for wheelchair propulsion. Also,
relative muscle forces were lower during handcycling. The largest differences between handbike and wheelchair propulsion were found in the supraspinatus (4. 5% vs. 20. 7%), infraspinatus (3. 7% vs. 16. 5%) and biceps (5. 0% vs. 17. 7%).
Conclusion: Due to continuous force application in hand­cycling, shoulder load was lower compared with wheelchair propulsion. Furthermore, muscles that are prone to overuse injuries were less stressed during handcycling. Therefore, handcycling may be a good alternative for outdoor mobility and may help prevent overuse injuries of the shoulder complex.