MRI evaluation of shoulder pathologies in wheelchair users with spinal cord injury and the relation to shoulder pain

Objective: To investigate the prevalence of rotator cuff and long head of the biceps pathologies in manual wheelchair (MWC) users with spinal cord injury (SCI). Design: Cross-sectional study. Setting: Academic medical center. Participants: MWC users with SCI. Outcome Measures: Participants demographic and anthropometric information, presence of shoulder pain, wheelchair users pain Index (WUSPI) scores, and MRI findings of shoulder pathologies including tendinopathy, tendon tears, and muscle atrophy. Results: Forty-four adult MWC users with SCI participated in the study. Fifty-nine percent of the participants reported some shoulder pain. The prevalence of any tendinopathy across the rotator cuff and the long head of biceps tendon was 98%. The prevalence of tendinopathy in the supraspinatus was 86%, infraspinatus was 91%, subscapularis was 75%, and biceps was 57%. The majority of tendinopathies had mild or moderate severity. The prevalence of any tears was 68%. The prevalence of tendon tears in the supraspinatus was 48%, infraspinatus was 36%, subscapularis was 43%, and biceps was 12%. The majority of the tears were partial-thickness tears. Participants without tendon tears were significantly younger (p < 0.001) and had been dependent on wheelchair for significantly shorter time (p = 0.005) than those with tendon tears. Conclusion: Mild and moderate shoulder tendinopathy and partial-thickness tendon tears were highly prevalent in MWC users with SCI. Additionally, the findings of this study suggest that strategies for monitoring shoulder pathologies in this population should not be overly reliant on patient-reported pain, but perhaps more concerned with years of wheelchair use and age.

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Functional Electrical Stimulation Rowing in Manual Wheelchair Users with Spinal Cord Injury and Shoulder Pain

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2015.08.200 ◽

2015 ◽

Vol 96 (10) ◽

pp. e59-e60

Author(s):

Susan R. Wilbanks ◽

Sean Pool ◽

Rebecca Rogers ◽

C. Scott Bickel

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Electrical Stimulation ◽

Shoulder Pain ◽

Functional Electrical Stimulation ◽

Wheelchair Users ◽

Manual Wheelchair ◽

Cord Injury

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Pain and its impact on functioning and disability in manual wheelchair users with spinal cord injury: a protocol for a mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2020-044152 ◽

2021 ◽

Vol 11 (1) ◽

pp. e044152

Author(s):

Mokgadi Kholofelo Mashola ◽

Elzette Korkie ◽

Diphale Joyce Mothabeng

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

South African ◽

Phase 1 ◽

Pain Medication ◽

Self Management ◽

Medication Misuse ◽

Wheelchair Users ◽

Manual Wheelchair ◽

Cord Injury

IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).Ethics and disseminationApproval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.

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