A pilot study to evaluate micro-fragmented adipose tissue injection under ultrasound guidance for the treatment of refractory rotator cuff disease in wheelchair users with spinal cord injury

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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Inertial Measurement Unit–Derived Ergonomic Metrics for Assessing Arm Use in Manual Wheelchair Users With Spinal Cord Injury: A Preliminary Report

Topics in Spinal Cord Injury Rehabilitation ◽

10.46292/sci20-00059 ◽

2021 ◽

Vol 27 (3) ◽

pp. 12-25

Author(s):

Omid Jahanian ◽

Meegan G. Van Straaten ◽

Brianna M. Goodwin ◽

Stephen M. Cain ◽

Ryan J. Lennon ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Rotator Cuff ◽

Living Environment ◽

Measurement Unit ◽

Cross Sectional ◽

Wheelchair Users ◽

Inertial Measurement ◽

Cord Injury ◽

Potential Risk Factors

Background: Individuals with spinal cord injury (SCI) who use manual wheelchairs (MWCs) have a higher rate of rotator cuff pathology progression than able-bodied individuals. Objectives: This study aimed to test the ability of risk and recovery metrics of arm use to differentiate between (1) MWC users with SCI and matched able-bodied participants (cross-sectional matched-sample study) and (2) MWC users with rotator cuff pathology progression over 1 year from those without pathology progression (longitudinal study). Methods: Thirty-four MWC users and 34 age- and sex-matched able-bodied individuals were recruited. Upper arm risk (humeral elevation >60°) and recovery (static ≥5 seconds and humeral elevation <40°) metrics were calculated from wireless inertial measurement units (IMUs) worn on the upper arms and torso in the free-living environment. Two separate magnetic resonance imaging studies were completed and assessed for a subset of 16 MWC users approximately 1 year apart. Results: The frequency of risk events (p = .019), summated duration of recovery events (p = .025), and duration of each recovery event (p = .003) were higher for MWC users than able-bodied participants. The summated duration of risk events (p = .047), frequency of risk events (p = .027), and risk to recovery ratio (p = .02) were higher and the summated duration of recovery events (p = .036) and frequency of recovery events (p = .047) were lower for MWC users with rotator cuff pathology progression (n = 5) compared to those without progression (n = 11). Conclusion: IMU-derived metrics quantifying arm use at postures >60° and risk to recovery ratios may provide insights of potential risk factors for rotator cuff pathology progression.

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233-LB: Spinal Cord Injury Inhibited-FGF21 Signaling Is Associated with Dysregulation of Metabolic Gene Expression in Mouse Liver and Adipose Tissue

Diabetes ◽

10.2337/db20-233-lb ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 233-LB

Author(s):

XIN-HUA LIU ◽

LAUREN HARLOW ◽

ZACHARY GRAHAM ◽

JOSHUA F. YARROW ◽

KENNETH CUSI ◽

...

Keyword(s):

Gene Expression ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Adipose Tissue ◽

Mouse Liver ◽

Metabolic Gene ◽

Metabolic Gene Expression ◽

Cord Injury

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The Effects of Hand-bike Exercise Equipment in People with Spinal Cord Injury: A pilot study : A Pilot Study

Korean Journal of Sports Science ◽

10.35159/kjss.2018.06.27.3.983 ◽

2018 ◽

Vol 27 (3) ◽

pp. 983-991

Author(s):

So-Eun Lee ◽

Dong-Il Kim

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pilot Study ◽

Cord Injury ◽

Exercise Equipment

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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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