Abstract：
More than 80% of adult manual wheelchair users with spinal cord injuries will experience shoulder pain. Females and those with decreased shoulder dynamics variability are more likely to experience pain in adulthood. Sex-related differences in shoulder dynamics variability during pediatric manual wheelchair propulsion may influence the lifetime risk of pain. We evaluated the influence of sex on 3-dimensional shoulder complex joint dynamics variability in 25 (12 females and 13 males) pediatric manual wheelchair users with spinal cord injury. Within-subject variability was quantified using the coefficient of variation. Permutation tests evaluated sex-related differences in variability using an adjusted critical alpha of P = .001. No sex-related differences in sternoclavicular or acromioclavicular joint kinematics or glenohumeral joint dynamics variability were observed (all P ≥ .042). Variability in motion, forces, and moments are considered important components of healthy joint function, as reduced variability may increase the likelihood of repetitive strain injury and pain. While further work is needed to generalize our results to other manual wheelchair user populations across the life span, our findings suggest that sex does not influence joint dynamics variability in pediatric manual wheelchair users with spinal cord injury.
摘要：
超过80%的患有脊髓损伤的成人手动轮椅使用者会经历肩痛。女性和肩关节动力学变异性降低的女性在成年期更有可能经历疼痛。小儿手动轮椅推进过程中肩部动力学变异性的性别相关差异可能会影响终生疼痛的风险。我们评估了性别对25名（12名女性和13名男性）患有脊髓损伤的小儿手动轮椅使用者的3维肩关节复杂关节动力学变异性的影响。使用变异系数量化受试者内变异性。置换检验使用P=.001的调整后的临界α来评估变异性的性别相关差异。未观察到胸锁关节或肩锁关节运动学或盂肱骨关节动力学变异性的性别相关差异（均P≥.042）。运动的变化，部队,时刻被认为是健康关节功能的重要组成部分，因为减少的变异性可能会增加重复性劳损和疼痛的可能性。虽然需要进一步的工作来将我们的结果推广到整个生命周期的其他手动轮椅使用者群体，我们的研究结果表明,性别不影响脊髓损伤的小儿手动轮椅使用者的关节动力学变异性.
