scholarly journals The Relationship between Clinical Tests, Ultrasound Findings and Selected Field-Based Wheelchair Skills Tests in a Cohort of Quadriplegic Wheelchair Rugby Athletes: A Pilot Study

2021 ◽  
Vol 11 (9) ◽  
pp. 4162
Author(s):  
Lucrezia Tognolo ◽  
Alfredo Musumeci ◽  
Andrea Pignataro ◽  
Nicola Petrone ◽  
Michael Benazzato ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Rating Scale ◽  
Clinical Tests ◽  
Wheelchair Rugby ◽  
Manual Wheelchair ◽  
Shoulder Pathology ◽  
Cord Injury ◽  
Pathologic Findings ◽  
The Relationship

Manual wheelchair use may determine shoulder joint overload and rotator cuff injury. Chronic shoulder pathologies can also influence the propulsion ability of wheelchair athletes with spinal cord injury (SCI) during sport activities. However, the relationship between shoulder pathology and wheelchair performances has never been explored. Therefore, the study aimed to investigate the correlation between shoulder pathologic findings with clinical tests and ultrasonography evaluation and the results of wheelchair performance tests. Nineteen quadriplegic wheelchair rugby players were evaluated to investigate the association between clinical and ultrasound shoulder pathologic findings and their correlation with the performance of field-based selected wheelchair skills tests (WSTs). The outcome measures were the International Wheelchair Rugby Classification Score, dominant and non-dominant Physical Examination Shoulder Score, and dominant and non-dominant Ultrasound Shoulder Pathology Rating Scale (USPRS). The WST was measured at the beginning and at one-year follow-up. A statistically significant correlation was found between the time since SCI and dominant USPRS (p < 0.005). The non-dominant USPRS was strongly related to WST at the beginning (p < 0.005) and the end of the study (p < 0.05). Data suggest that the severity of the non-dominant shoulder pathology detected on the ultrasound is related to lower performance on the WST. Chronic manual wheelchair use could be responsible for dominant SCI shoulder joint and rotator cuff muscle damage, while non-dominant USPRS could be related to performance on the WST.

scholarly journals Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review

2019 ◽  
Vol 10 (2) ◽  
pp. 195-208
Author(s):  
Yoshihiro Katsuura ◽  
Jeremy Bruce ◽  
Samuel Taylor ◽  
Lawrence Gullota ◽  
Han Jo Kim
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Rotator Cuff ◽  
Cochrane Collaboration ◽  
Rotator Cuff Tears ◽  
Careful Examination ◽  
Shoulder Pathology ◽  
Pain Pathways ◽  
Spine Pathology ◽  
The Relationship

Study Design: Systematic review. Objective: To assess the current literature regarding the relationship between the shoulder and the spine with regard to (1) overlapping pain pathways; (2) differentiating history, exam findings, and diagnostic findings; (3) concomitant pathology and optimal treatments; and (4) cervical spine-based etiology for shoulder problems. Methods: A systematic literature search was performed according to the guidelines set forth by the Cochrane Collaboration. Studies were included if they examined the clinical, anatomical, or physiological overlap between the shoulder and cervical spine. Two reviewers screened and selected full texts for inclusion according to the objectives of the study. Quality of evidence was graded using OCEBM (Oxford Center for Evidence Based Medicine) and MINORS (Methodological Index for Nonrandomized Studies) scores. Results: Out of 477 references screened, 76 articles were included for review and grouped into 4 main sections (overlapping pain pathways, differentiating exam findings, concomitant/masquerading pathology, and cervical spine-based etiology of shoulder pathology). There is evidence to suggest cervical spine pathology may cause shoulder pain and that shoulder pathology may cause neck pain. Specific examination tests used to differentiate shoulder and spine pathology are critical as imaging studies may be misleading. Diagnostic injections can be useful to confirm sources of pain as well as predicting the success of surgery in both the shoulder and the spine. There is limited evidence to suggest alterations in the relationship between the spine and the scapula may predispose to shoulder impingement or rotator cuff tears. Moreover, cervical neurological lesions may predispose patients to developing rotator cuff tears. The decision to proceed with shoulder or spine surgery first should be delineated with careful examination and the use of shoulder and spine diagnostic injections. Conclusion: Shoulder and spine pathology commonly overlap. Knowledge of anatomy, pain referral patterns, shoulder kinematics, and examination techniques are invaluable to the clinician in making an appropriate diagnosis and guiding treatment. In this review, we present an algorithm for the identification and treatment of shoulder and cervical spine pathology.

The effect of level of spinal cord injury on shoulder joint kinetics during manual wheelchair propulsion

2001 ◽  
Vol 16 (9) ◽  
pp. 744-751 ◽  
Author(s):  
Kornelia Kulig ◽  
Craig J Newsam ◽  
Sara J Mulroy ◽  
Sreesha Rao ◽  
JoAnne K Gronley ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Shoulder Joint ◽  
Wheelchair Propulsion ◽  
Joint Kinetics ◽  
Manual Wheelchair ◽  
Cord Injury

scholarly journals The Impact of an Assistive Pole, Seat Configuration, and Strength in Paralympic Seated Throwing

2017 ◽  
Vol 12 (7) ◽  
pp. 977-983 ◽  
Author(s):  
Alysha Hyde ◽  
Luke Hogarth ◽  
Mark Sayers ◽  
Emma Beckman ◽  
Mark J. Connick ◽  
...  
Keyword(s):  
Grip Strength ◽  
Upper Body ◽  
Trunk Flexion ◽  
Kinematic Data ◽  
Wheelchair Rugby ◽  
Significant Difference ◽  
Cord Injury ◽  
The Impact ◽  
The Relationship ◽  
Trunk Strength

Purpose:To quantify the influence of the assistive pole, seat configuration, and upper-body and trunk strength on seated-throwing performance in athletes with a spinal-cord injury (SCI).Methods:Ten Paralympic athletes competing in wheelchair rugby, basketball, or athletics (seated throws) participated in 2 randomized sessions: seated throwing and strength tests. Participants threw a club from a custom-built throwing chair, with and without a pole. 3D kinematic data were collected (150 Hz) for both conditions using standardized and self-selected seat configurations. Dominant and nondominant grip strength were measured using a dynamometer, and upper-body and trunk strength were measured using isometric contractions against a load cell.Results:Seated throwing with an assistive pole resulted in significantly higher hand speed at release than throwing without a pole (pole = 6.0 ± 1.5 m/s, no pole = 5.3 ± 1.5 m/s; P = .02). There was no significant difference in hand speed at release between standardized and self-selected seating configurations during seated throwing with or without an assistive pole. Grip strength (r = .59–.77), push/pull synergy (r = .81–.84), and trunk-flexion (r = .50–.58) strength measures showed large and significant correlations with hand speed at release during seated throwing with and without an assistive pole.Conclusions:This study has demonstrated the importance of the pole for SCI athletes in seated throwing and defined the relationship between strength and seated-throwing performance, allowing us to better understand the activity of seated throws and provide measures for assessing strength that may be valid for evidence-based classification.

Shoulder MRI in asymptomatic elite volleyball athletes shows extensive pathology

2019 ◽  
Vol 5 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Christopher Sy Lee ◽  
Nicole Hamilton Goldhaber ◽  
Shane M Davis ◽  
Michelle L Dilley ◽  
Aaron Brock ◽  
...  
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Shoulder Joint ◽  
Rotator Cuff Tears ◽  
Low Grade ◽  
Shoulder Injuries ◽  
Overhead Athletes ◽  
Shoulder Pathology ◽  
Volleyball Players ◽  
Elite Level

ObjectivesElite overhead athletes, such as volleyball players, are predisposed to shoulder injuries due to repetitive overhead movement and overloading of the shoulder joint and surrounding muscles and ligaments. Returning to play at an elite level following shoulder surgery is often not possible. We hypothesised that MRI of elite volleyball players’ dominant shoulders would demonstrate extensive asymptomatic shoulder pathology that does not prevent the athlete from competing. To test this hypothesis, the objective of this observational study was to evaluate the history, physical examination and MRI findings to determine the incidence of asymptomatic shoulder pathology. We believe this knowledge will improve outcomes in the management of shoulder pain in overhead athletes and prevent unnecessary surgical procedures.Methods26 asymptomatic elite volleyball players of the US Men’s and Women’s National Indoor Volleyball Teams underwent MRI (0.27 Tesla) of their dominant shoulders and physical examinations of both shoulders. Asymptomatic was defined as being able to play volleyball without restrictions. The imaging was reviewed by two fellowship-trained musculoskeletal radiologists. Visual Analogue Pain scores, range of motion, strength, University of California, Los Angeles and American Shoulder and Elbow Society outcome scores were measured and recorded.ResultsThe mean age at the time of MRI was 25.53 years old (range: 21 to 30 years). There were 14 male and 12 female players. 23 athletes had rotator cuff tendinosis (88.5%) and 17 athletes had partial rotator cuff tears (65.4%). 13 of these tears involved the supraspinatus with five moderate-to-high-grade and eight moderate-to-low-grade. Two tears involved the infraspinatus, and there were two subscapularis tears. Six athletes had a labral tear (23.1%) and six additional athletes had labral fraying (23.1%). All MRIs showed abnormal pathology.ConclusionThese findings support the notion that elite-level volleyball players display asymptomatic shoulder joint pathology in their dominant arm, particularly of the rotator cuff and labrum, which do not limit their ability to participate.Level of evidenceV

scholarly journals Shoulder MRI Findings in Manual Wheelchair Users with Spinal Cord Injury

2020 ◽  
Author(s):  
Omid Jahanian ◽  
Meegan G. Van Straaten ◽  
Brianna M. Goodwin ◽  
Ryan J. Lennon ◽  
Jonathan D. Barlow ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Rotator Cuff ◽  
Mri Findings ◽  
Wheelchair Users ◽  
Manual Wheelchair ◽  
Cord Injury ◽  
Tendon Tears ◽  
Long Head ◽  
Shoulder Pathologies

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.

Arthroscintigraphy in Suspected Rotator Cuff Rupture

1998 ◽  
Vol 37 (08) ◽  
pp. 272-278 ◽  
Author(s):  
S. Gratz ◽  
G. Köster ◽  
T. Behr ◽  
R. Vosshenrich ◽  
E. Grabbe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Clinical Signs ◽  
Diagnostic Efficiency ◽  
Rotator Cuff Rupture ◽  
Lower Viscosity ◽  
Rotator Cuff Lesion ◽  
Shoulder Region ◽  
Degenerative Alterations ◽  
Additional Value

Summary Aim: In order to evaluate the diagnostic efficiency of arthroscintigraphy in suspected rotator cuff ruptures this new imaging procedure was performed 20 times in 17 patients with clinical signs of a rotator cuff lesion. The scintigraphic results were compared with sonography (n = 20), contrast arthrography (n = 20) and arthroscopy (n = 10) of the shoulder joint. Methods: After performing a standard bone scintigraphy with intravenous application of 300 MBq 99m-Tc-methylene diphosphonate (MDP) for landmarking of the shoulder region arthroscintigraphy was performed after an intraarticular injection of 99m-Tc microcolloid (ALBURES 400 μCi/5 ml). The application was performed either in direct combination with contrast arthrography (n = 10) or ultrasound conducted mixed with a local anesthetic (n = 10). Findings at arthroscopical surgery (n = 10) were used as the gold standard. Results: In case of complete rotator cuff rupture (n = 5), arthroscintigraphy and radiographic arthrography were identical in 5/5. In one patient with advanced degenerative alterations of the shoulder joint radiographic arthrography incorrectly showed a complete rupture which was not seen by arthroscintigraphy and endoscopy. In 3 patients with incomplete rupture, 2/3 results were consistant. A difference was seen in one patient with a rotator cuff, that has been already revised in the past and that suffered of capsulitis and calcification. Conclusion: Arthroscintigraphy is a sensitive technique for detection of rotator cuff ruptures. Because of the lower viscosity of the active compound, small ruptures can be easily detected, offering additional value over radiographic arthrography and ultrasound, especially for evaluation of incomplete cuff ruptures.

scholarly journals Study of the Interaction between Executive Function and Adaptive Behavior at School in Girls with Fragile X Syndrome

Genes ◽  
2021 ◽  
Vol 12 (8) ◽  
pp. 1108
Author(s):  
Lorena Joga-Elvira ◽  
Jennifer Martinez-Olmo ◽  
María-Luisa Joga ◽  
Carlos Jacas ◽  
Ana Roche-Martínez ◽  
...  
Keyword(s):  
Executive Function ◽  
Executive Functions ◽  
Fragile X Syndrome ◽  
Adaptive Behavior ◽  
Neuropsychological Tests ◽  
Rating Scale ◽  
Fragile X ◽  
School Setting ◽  
Control Group ◽  
The Relationship

The aim of this research is to analyze the relationship between executive functions and adaptive behavior in girls with Fragile X syndrome (FXS) in the school setting. This study is part of a larger investigation conducted at the Hospital Parc Tauli in Sabadell. The sample consists of a total of 40 girls (26 with FXS and 14 control) aged 7–16 years, who were administered different neuropsychological tests (WISC-V, NEPSY-II, WCST, TOL) and questionnaires answered by teachers (ABAS-II, BRIEF 2, ADHD Rating Scale). The results show that there is a greater interaction between some areas of executive function (cognitive flexibility, auditory attention, and visual abstraction capacity) and certain areas of adaptive behavior (conceptual, practical, social, and total domains) in the FXS group than in the control group. These results suggest that an alteration in the executive functions was affecting the daily functioning of the girls with FXS to a greater extent.

scholarly journals 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 ◽  
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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