Tendon health in manual wheelchair users: A scoping review protocol

Abstract Objective: This scoping review aims to characterize the extent and type of evidence related to tendon morphology in manual wheelchair users. Introduction: Tendons are biological tissues primarily composed of type I collagen fibers, which function by transmitting the load generated from muscles to bones. Despite each tendon’s similarities in composition, their shapes and sizes vary based on functional demands. For individuals who use manual wheelchairs for daily mobility, repetitive propulsion alters the demand for muscle-tendon units in the upper extremity whereas the lower extremity tendons undergo chronic underloading. This review aims to synthesize the current literature and identify gaps in evidence related to tendon health through quantitative tendon imaging in manual wheelchair users. Inclusion criteria: The population of interest in this scoping review is adult manual wheelchair users. The concept to be explored will be characterizing tendon morphology of upper and lower extremity tendons in the context of diagnostic imaging. Methods: This scoping review will be conducted in accordance with the methodological guidance of the Joanna Briggs Institute (JBI). The search strategy will aim to locate both published and unpublished English language studies from inception to present. The following databases will be searched by a health sciences librarian: Medline (PubMed), Embase, Web of Science, and ProQuest Dissertations & Theses Global. Two independent reviewers will extract data and categorize into tabular and figure forms and generate themes based on participants demographic, arthrometric, and morphological findings from diagnostic imaging. Keywords: Imaging; morphology; paraplegia; tendon; wheelchair This scoping review aims to characterize tendon morphology in manual wheelchair users. We are primarily interested in studies that use quantitative imaging methods to characterize tendon structure. Given the emerging nature of research for manual wheelchair users, a scoping review is necessary to map the existing literature comprehensively, identify key themes, and determine the scope of research conducted to date, providing a foundation for future systematic reviews or research agendas. A preliminary search of MEDLINE, the Cochrane Database of Systematic Reviews, the Open Science Framework, and JBI Evidence Synthesis found no current or underway scoping reviews. Therefore, this scoping review aims to identify structural and organizational tendon components that have been studied for full-time manual wheelchair users and identify and analyze gaps present in the current knowledge base.