Investigation of Relationship between Wrist Kinematics and Median Nerve Health in Paraplegic Manual Wheelchair Users at Two Time-points

Kevin K. Toosi, MD, MS1,3,4 , Bradley G. Impink, BS1,4 , Jennifer L. Collinger, MS1,4 , Jennifer Yang, MD3,4 , Alicia M. Koontz, PhD, RET2,4 , Michael L. Boninger, MD1,2,3,4

1 Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
2 Deptartment of Rehabilitation Science and Technology, University of Pittsburgh
3 Department of Physical Medicine and Rehabilitation, University of Pittsburgh
4 Human Engineering Research Laboratories, Highland Drive VA Medical Center, Pittsburgh, PA


Wrist kinematics variables were measured in manual wheelchair users during wheelchair propulsion and the results were compared to those of subjects’ nerve conduction studies at two visits. Mean time between visits was 53.8±24.9 months. The correlational analyses demonstrated that maximum radial deviation had significantly negative correlation, and maximum ulnar deviation had significantly positive correlation with the median nerve health parameters in non-dominant hands during the second visit. These findings suggest that the correlated variables could be used to predict the median nerve health status over time.


Carpal tunnel syndrome, median nerve, manual wheelchair users, wrist biomechanics


This material is the result of work supported with resources and the use of facilities at the Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, and the following funding sources: National Institute on Disability and Rehabilitation Research grant number H133A011107, Veterans Affairs Office of Academic Affiliations grant number OAA01 (Post-Residency Advanced Fellowship in Spinal Cord Injury), the Veterans Affairs Rehabilitation Research and Development Service, United States Department of Veterans Affairs grant numbers B869RA, B2290T and B3057R, and the NIH Training Rehabilitation Clinicians for Research Careers, T32 HD049307.

Author Contact Information:

Kevin K. Toosi
Human Engineering Research Laboratories
7180 Highland Drive
Building 4, 2nd Floor, East Wing, 151R-1
Pittsburgh, PA 15206
Phone: 412-954-5282