The picture shows Becki, who has quadriplegia due to a C5-C6 spinal cord injury, doing the shoulder external rotation exercise on the UPPERTONE adaptive physical education and therapy system.

Because it develops muscles that can compensate for the triceps during transfers, the external shoulder rotation is particularly beneficial for people who have weak or no triceps because of their quadriplegia (tetraplegia).

In addition, this exercise is also particularly useful for counteracting the tight internal rotators that people with quadriplegia or spinal cord injury often develop when propelling manual wheelchairs.