Introduction
People who use a manual wheelchair as their primary or
only source of locomotion are subject to shoulder problems
after several years of usage. The length of time
before the onset of shoulder problems can vary from 5
to 20 years, depending on factors such as the age of the
individual, the level of injury, and the type of use.
Moreover, people frequently adopt techniques for transfers,
loading their wheelchairs, and miscellaneous upper
extremity activities that are responsible for part of the
shoulder problems experienced later.1–3 This complication
may compromise people’s daily activities, cause