The interaction between wheelchair configuration and wheeling performance in wheelchair tennis: a narrative review

Exploring the biomechanical link between wheelchair propulsion, shoulder injury and shoulder pain: A scoping review

A high prevalence of shoulder pain and injuries exists in manual wheelchair users (MWUs). Wheelchair propulsion is believed to be related to shoulder pain and injuries, but the exact cause-effect relation remains unclear. The research questions of this narrative review were: 1) What are the differences in propulsion biomechanics for MWUs with different levels of shoulder pain and injuries? 2) How much proof is there for a cause-effect relationship between wheelchair propulsion and the development of shoulder pain and injuries in MWUs? A systematic literature search identified 18 articles matching the selection criteria. MWUs with shoulder pain or injury exhibited different propulsion patterns than those without. A long push angle, low stroke frequency, low peak forces and sufficient variability possibly relate to lower levels of shoulder pain and injuries. However, it is not yet clear whether this propulsion technique decreases the risk of developing shoulder pain and injuries, or if it serves as a protective mechanism of MWUs who have already developed pain and injuries. More longitudinal studies, including real-life biomechanical measurements, with a focus on within-subject changes are needed to better understand the bidirectional and time-varying biomechanical relationship between shoulder pain and injuries and wheelchair propulsion.

Kinematic and muscle co-activation patterns in the dominant arm across forehand stroke phases in wheelchair tennis

Objective

This study investigated upper limb kinematics and muscle co-activation in wheelchair tennis players during the forehand stroke. By analyzing linear and angular kinematic variables alongside muscle co-activation patterns, the study aimed to provide insights into the biomechanical mechanisms supporting forehand stroke performance.

Method

Fifteen professional male wheelchair tennis players (height: 163.9 ± 2.05 cm; mass: 64.1 ± 3.07 kg; age: 32.2 ± 7.97 years) participated in this study. Electromyographic data from six muscles around the dominant arm joints were recorded using the Myon system. Four fixed GoPro Hero 8 cameras (120 Hz) captured 3D video, and kinematic analyses were performed using the APAS system. The forehand stroke was analyzed across three phases: (1) backswing, (2) forwardswing, and (3) follow-through.

Results

The results showed significant phase-specific changes in muscle co-activation for the shoulder (p < 0.001), elbow (p < 0.005), and wrist (p < 0.01). Muscle co-activation was highest during the backswing phase, decreased during the forwardswing, and increased again during the follow-through phase. This pattern reflects the need for joint stability and control, particularly when changing stroke direction and slowing the arm after impact.

Conclusion

These findings provide novel insights into the kinematic and neuromuscular mechanisms underlying the forehand stroke in wheelchair tennis. The data provide hypotheses about potential training and rehabilitation strategies that should be tested by prospective studies. The results also highlight the unique demands of wheelchair tennis, contributing to inclusive, evidence-based approaches to enhancing performance and safety in disability sports.

The Effect of a Newly Developed Hand Rim on Mobility Performance and Propulsion Technique in Wheelchair Tennis Players

PURPOSE

To investigate the effect of a newly developed hand rim in wheelchair tennis players from a lab and field perspective.

METHODS

Nine wheelchair tennis players performed a set of field and lab tests with the new rim (NR) and regular rim on the racket side. Each player had a 60- to 120-minute regular training session with the NR. Three wheelchair tennis field tests (20-m sprint, Illinois, spider) were completed on a hard court using inertial measurement units. The inertial measurement units enabled analysis of linear/rotational velocity and acceleration. In the lab, two 4-minute submaximal tests (at 1.5 and 2 m/s, 0.2 W/kg), followed directly by a 5-second sprint, on a wheelchair ergometer were completed. Force and velocity were measured continuously throughout all tests. Mixed linear models investigated the effect between the 2 hand rims.

RESULTS

During the spider test, mean rotational velocity to the racket side (-2%, P = .005) was lower in the NR, and end times were similar between hand-rim conditions. No differences were observed in the 20-m sprint and Illinois field tests. In the lab, contact angle (+6%, P = .04), cycle time (+12%, P = .007), and work per push (+13%, P = .005) were higher in the NR during submaximal propulsion. Work per push (+13%, P = .007), peak velocity (+3%, P < .001), and distance covered (+4%, P = .02) were higher with the NR during the 5-second sprint test.

CONCLUSIONS

The NR seems slightly favorable compared with the regular rim during performance testing on a wheelchair ergometer in wheelchair tennis players. A longer practice time might show more insights between the hand-rim types.

Changes in Electromyographic Activity of the Dominant Arm Muscles during Forehand Stroke Phases in Wheelchair Tennis

The aim of this study was to determine the muscle activations of the dominant arm during the forehand stroke of wheelchair tennis. Five players participated in the present study (age: 32.6 ± 9.9 years; body mass: 63.8 ± 3.12 kg; height: 164.4 ± 1.7 cm). The electrical muscle activity of six dominant arm muscles was recorded using an sEMG system. A significant effect of the muscle's activity was observed, and it was shown that the muscle activation was significantly higher in the execution phase compared to the preparation phase in the anterior deltoid and biceps brachii (34.98 ± 10.23% and 29.13 ± 8.27%, p < 0.001); the posterior deltoid, triceps brachii, flexor carpi radialis, and extensor carpi radialis were higher in the follow-through phase than in the execution phase (16.43 ± 11.72%, 16.96 ± 12.19%, 36.23 ± 21.47% and 19.13 ± 12.55%, p < 0.01). In conclusion, it was determined that the muscle activations of the dominant arm muscles demonstrate variances throughout the phases of the forehand stroke. Furthermore, the application of electromyographic analysis to the primary arm muscles has been beneficial in understanding the muscular activity of the shoulder, elbow, and wrist throughout the various phases of the forehand stroke in wheelchair tennis.

Wheelchair basketball, health, competitive analysis, and performance advantage: a review of theory and evidence

The purpose of this study was to review the various risks and benefits of wheelchair basketball (WB) and explore some of the research which outlines factors that influence WB player performance and conditioning. WB offers several physical and psychological advantages. Physically, it can improve muscle strength, endurance, and cardiovascular fitness while decreasing the prevalence of chronic physical disorders. From a psychological standpoint, WB has been shown to alleviate anxiety and feelings of depression while also creating and improving social relationships. Despite the many benefits, WB can cause injuries, particularly in the upper extremities, and preventative measures should be employed. WB necessitates intense intermittent efforts and athletes must maintain excellent cardiovascular fitness, strength, and muscular endurance. Healthy sleeping patterns have also been shown to improve performance in WB players. Wheelchair mobility and biomechanical variables as well as wheelchair size and weight appear to be critical success elements in WB. WB can be a powerful tool for coaches and therapists to boost the physical and emotional health of individuals with disabilities and motivate them to participate in team-based sport.

“The show must go on”: How Paralympic athletes safeguarded their mental well-being and motivation to train for the postponed Tokyo 2020 games

Introduction

After the decision to postpone the Tokyo 2020 Games due to the COVID-19 pandemic, athletes had to adjust to a novel situation with feelings of uncertainty and insecurity. Grounded in Self-Determination Theory, this study was the first to examine whether different motivational profiles among Paralympic athletes can be identified, and to link these profiles with the athletes’ emotional, cognitive, and performance-related outcomes in times of a pandemic.

Methods

Five months before the start of the Paralympic Games, the participants (N = 32; mean age = 33.2 ± 6.8 years) completed an online questionnaire measuring their demographics, basic psychological needs, perceived stress, depressive symptoms, general well-being, and motivational self-regulation strategies. Two months after the Games, they completed a second online questionnaire measuring their actual and perceived performance at the past Games.

Results

Through K-means cluster analysis, three distinct clusters were identified based on the athletes’ dominant type of motivation, these are, dominantly amotivated (n = 11), autonomously motivated (n = 12), and controlled motivated (n = 9). Comparisons of athletes’ emotional, cognitive, and performance-related outcomes depending on their motivational profile revealed that the athletes with a dominantly amotivated profile had the least adaptive outcomes (i.e., low need satisfaction, high need frustration, and more depressive symptoms). Athletes with a dominantly autonomously motivated profile made less use of controlling self-motivating strategies compared to the other two profiles. Moreover, their actual performance at the Paralympic Games was better.

Discussion

Although none of the athletes were at severe risk for depression or showed extremely high levels of stress, these results confirm that improving the quality of athletes’ motivation can safeguard their well-being and enhance performance in Paralympic Sports.

Influence of Successive Wheelchair Tennis Matches on Handgrip Strength in High-Level Male Players

The purpose of this study was to examine the effects on upper strength in high-level male players playing four successive wheelchair tennis (WT) matches. Eight international WT players took part in a competition, playing one match per day over four consecutive tournament days. Before and after the match, the maximal isometric handgrip strength was measured on the dominant and non-dominant hand. Additionally, each player was equipped with one radiofrequency and IMU device on their wheelchair to control his activity profile (distance). The results showed significant differences between successive matches, with decreasing dominant handgrip strength (p = 0.02, η² = 0.043), and there was a significant interaction between successive matches and the accumulated distance (p = 0.013, η² = 0.049). The pre- and post-match strength values of the dominant hand decreased throughout the matches over a number of days, and post hoc analysis showed differences between the first and fourth matches only in pre-match strength (49.06 ± 6.96 vs. 45.94 ± 7.1; p = 0.045; ES: 1.04) but not in the non-dominant hand. Successive matches caused a decrease in the strength values of the WT players, mainly in the dominant hand. These results should be taken into account in the recovery and prevention of injuries in competitions with successive matches.

Influence of Wheelchair Type on Kinematic Parameters in Wheelchair Rugby

Introduction

In wheelchair rugby, players use either an offensive or defensive wheelchair depending on their field position and level of impairment. Performance of wheelchair rugby players is related to several parameters, however it is currently unclear if differences in performance are related to wheelchair type or no: the effect of wheelchair type on performance variables has not been evaluated. The aim of this study was to compare offensive and defensive wheelchairs on performance variables during a straight-line sprint.

Methods

Thirteen able-bodied people performed two 20 m sprint trials: one with an offensive and one with a defensive wheelchair. Data were collected using inertial measurement units fixed on the wheelchair. Peak wheelchair velocities and left-right asymmetries in peak wheel velocities were measured during the acceleration and constant peak velocity phases. Sprint time, cycle frequency, and mean and maximum velocity were calculated over the entire sprint.

Results

The peak velocities of the first 2 pushes (acceleration phase) were significantly higher with the defensive than the offensive wheelchair (p &lt; 0.04 and p &lt; 0.02). Mean and maximum sprint velocity were significantly higher (p &lt; 0.03 and p &lt; 0.04, respectively) with the defensive wheelchair. Cycle frequency and asymmetry did not differ between wheelchairs.

Conclusion

Performance was higher with the defensive than the offensive wheelchair, suggesting that the frequent finding that the higher performance of offensive as compared to defensive players is not related to the use of an offensive wheelchair.

How Was Studied the Effect of Manual Wheelchair Configuration on Propulsion Biomechanics: A Systematic Review on Methodologies

Background

For both sports and everyday use, finding the optimal manual wheelchair (MWC) configuration can improve a user's propulsion biomechanics. Many studies have already investigated the effect of changes in MWC configuration but comparing their results is challenging due to the differences in experimental methodologies between articles.

Purpose

The present systematic review aims at offering an in-depth analysis of the methodologies used to study the impact of MWC configuration on propulsion biomechanics, and ultimately providing the community with recommendations for future research.

Methods

The reviewing process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart on two databases (Scopus and PubMed) in March 2022.

Results

Forty-five articles were included, and the results highlighted the multiplicity of methodologies regarding different experimental aspects, including propulsion environment, experimental task, or measurement systems, for example. More importantly, descriptions of MWC configurations and their modifications differed significantly between studies and led to a lack of critical information in many cases.

Discussion

Studying the effect of MWC configuration on propulsion requires recommendations that must be clarified: (1) the formalism chosen to describe MWC configuration (absolute or relative) should be consistent with the type of study conducted and should be documented enough to allow for switching to the other formalism; (2) the tested MWC characteristics and initial configuration, allowing the reproduction or comparison in future studies, should be properly reported; (3) the bias induced by the experimental situation on the measured data must be considered when drawing conclusions and therefore experimental conditions such as propulsion speed or the effect of the instrumentation should be reported.

Conclusion

Overall, future studies will need standardization to be able to follow the listed recommendations, both to describe MWC configuration and mechanical properties in a clear way and to choose the experimental conditions best suited to their objectives.

A Scoping Review on Shoulder Injuries of Wheelchair Tennis Players: Potential Risk-Factors and Musculoskeletal Adaptations

Wheelchair tennis players are prone to develop shoulder injuries, due to the combination of wheelchair propulsion, overhead activities and daily wheelchair activities. A methodical literature search was conducted to identify articles on shoulder complaints in wheelchair tennis, wheelchair sports and tennis. The aims were to identify (1) type of shoulder complaints; (2) possible risk factors for the development of shoulder injuries; (3) musculoskeletal adaptations in the shoulder joint in wheelchair tennis players. Fifteen papers were included in this review, five on wheelchair tennis, three on wheelchair sports and seven on tennis. Type of shoulder complaints were acromioclavicular pathology, osteoarthritic changes, joint effusion and rotator cuff tears. Possible risk factors for the development of shoulder injuries in wheelchair tennis are overhead movements, repetitive activation of the anterior muscle chain and internal rotators, as well as a higher spinal cord injury level. Muscular imbalance with higher values for the internal rotators, increase in external range of motion, decrease in internal range of motion and reduced total arc of motion were the most common proposed musculoskeletal adaptations due to an unbalanced load. These presented risk factors and musculoskeletal adaptations might help researchers, coaches and wheelchair tennis players to prevent shoulder injuries.