Our overarching goal is to perform impactful and innovative research that improves the quality of life for person’s with a without disabilities. In line with that goal, we have three primary research themes:

Theme 1: Determining how the nervous and musculoskeletal systems adapt to manual wheelchair use across the entire lifespan.

The repetitive, demanding nature of manual wheelchair use can come with significant functional consequences. Many users experience neck pain (~60% of users), shoulder pain (~70% of users), and shoulder pathologies like rotator cuff tendinopathies and glenohumeral instability (~80% of users). This can have profound negative effects on quality of life through reduced participation in everyday activities and can increase the lifetime risk of secondary medical conditions like cardiovascular disease through reductions in physical activity. The prevalence of pain and pathology increases with age and depends on the age at which an individual began using a wheelchair. The nervous and musculoskeletal systems are extremely versatile, adapting to withstand whatever demands they experience. Our immediate goal is to determine how these systems adapt (anatomically and functionally) to wheelchair use across the lifespan. Our ultimate goal is to identify modifiable adaptations that predict the development of pain or pathology.

Theme 2: Establishing ergonomic standards for computer work to prevent neck pain in manual wheelchair users and non-users.

Neck pain is currently the fourth leading cause of physical disability across the entire United States population and effects up to 60% of manual wheelchair users. Neck pain has been linked to prolonged static or repetitive working conditions, like seated computer work and manual wheelchair use. Ergonomics recommendations (ANSI/HFES 100) for seated computer work aim to reduce the risk of neck pain by minimizing stress on key neck muscles through adjustments to computer monitor position and neck posture. Research from our group suggests that these recommendations alone may not be beneficial when positioning someone during seated computer work, and that seat recline angle should be considered. Unfortunately, most manual wheelchairs lack the capability to alter recline. Our goal is to develop ergonomics recommendations tailored specifically to manual wheelchair users and non-users by determining the relationships among ergonomic setup, neuromuscular function, and pain.

Theme 3: Determining the sex-specific mechanisms underlying shoulder and neck pain and pathology.

A significant sex-related health disparity exists regarding pain. Generally, females are far more likely to experience clinical, musculoskeletal, upper extremity, shoulder, and neck pain than males. Females are also less tolerant to multiple forms of pain, including thermal and pressure-based pain, and experience a temporal summation of shoulder pain, i.e., repeated, equally intense stimuli cause an increase in the experienced pain. Females may also experience shoulder pathologies, like rotator cuff tendinopathies or glenohumeral instability, at a greater rate than males. The mechanisms underlying these sex-related differences in pain and pathology have been largely ignored. We aim to increase equity in the prevention and rehabilitation of musculoskeletal conditions by determining the etiology of shoulder and neck pain and pathology through the lens of biological sex.