# Mechanisms of Rotator Cuff Injury During Manual Wheelchair Propulsion

> **NIH NIH R03** · UNIVERSITY OF MINNESOTA · 2024 · $74,377

## Abstract

Project Summary/Abstract
Shoulder pain and joint disease is a serious threat to health and mobility for manual wheelchair users living with
spinal cord injury. There are subsequent implications for functional independence, quality of life, caregiver
burden, and healthcare utilization. In particular, rotator cuff tears are devastating for these individuals as the
usual clinical course (repair) is not typically viable. Their upper extremities have become their primary means of
mobility, and post-surgical shoulder immobilization is impractical. As such, it is critical that shoulder joint health
is preserved for this population. In order to address the major challenges of preventing shoulder disease and
dysfunction progression for manual wheelchair users, we need to assess the impact of and need for various
interventions relative to rotator cuff soft tissue health. In addition to inverse dynamic calculations of joint torques
or electromyographic measures, measuring the impact of interventions on rotator cuff soft tissue compression is
an important advancement in mechanistic understanding and outcomes assessment. Our proposal will combine
existing data sets from the University of Minnesota (20 precise 3D shoulder reconstructions including soft tissue)
and Mayo Clinic (10 participants’ precise 3D shoulder kinematics during wheelchair propulsion) to measure
rotator cuff compression for 200 unique combinations of shoulder geometry and kinematics. Aim 1 will
“Characterize the effect of anatomical features and movement patterns on rotator cuff tendon compression
during manual wheelchair propulsion”. Clinicians and transformational scientists need to know the relative
impacts of motion and anatomy/geometry on rotator cuff stresses during wheelchair propulsion.
Outcomes of this investigation will inform both mechanistic investigations and clinical trials assessing preventive
interventions. In addition, methods to directly assess soft tissue impact are labor- and technology-intensive. Our
proposed Aim 2 will “Determine the capability of low-fidelity models to predict in vivo tendon compression during
manual wheelchair propulsion” by directly comparing high- and low-fidelity techniques. Successful completion
of this project will determine the necessity or benefit of labor-intensive, subject-specific models over
lower fidelity alternatives in studying rotator cuff tendon injury mechanisms, and preventative outcomes.
This knowledge can then be applied extensively in future work by our group and others, including assessment
of transfers and other functional activities. Appropriate sample sizes for future work can also be planned with the
knowledge gained through this proposed project. This project provides a unique opportunity for collaboration
between experienced investigators and to combine existing data to determine relative utility of various
approaches for larger scale investigation planning. Our approach is responsive to the NICHD Notice of Special
Interest...

## Key facts

- **NIH application ID:** 10812372
- **Project number:** 5R03HD110681-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** PAULA Marie LUDEWIG
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $74,377
- **Award type:** 5
- **Project period:** 2023-04-01 → 2025-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10812372

## Citation

> US National Institutes of Health, RePORTER application 10812372, Mechanisms of Rotator Cuff Injury During Manual Wheelchair Propulsion (5R03HD110681-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10812372. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*