Factors Associated With Shoulder Pain in Manual Wheelchair Users With Spinal Cord Injury

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Shoulder pain is a prevalent issue among manual wheelchair (MW) users with spinal cord injury (SCI).
• Understanding the contributing factors is vital for preventing upper extremity dysfunction.

Purpose of the Study:

• To explore the associations between shoulder pain and patient demographics, physical examination, wheelchair configuration, and imaging findings in MW users with SCI.

Main Methods:

• A cross-sectional study involving 30 MW users with SCI.
• Evaluated shoulder pain using the Wheelchair Users' Shoulder Pain Index (WUSPI).
• Assessed shoulder pathology with the Ultrasound Shoulder Pathology Rating Scale (USPRS) and Critical Shoulder Angle (CSA) from radiographs.
• Measured wheelchair setup parameters: rear axle-to-acromion distance and elbow angle.

Main Results:

• WUSPI scores correlated with duration of MW use and USPRS findings.
• Higher WUSPI was observed with a CSA of 35° or greater.
• Optimal wheelchair setup (recommended elbow angle and rear axle-acromion distance) was linked to lower WUSPI.
• Ultrasound detected pathologies missed by clinical tests in 41.7% to 79.3% of cases.

Conclusions:

• Proper manual wheelchair setup is crucial for mitigating shoulder pain in SCI.
• USPRS and CSA are valuable diagnostic and monitoring tools for shoulder pathology in this population.
• Early identification and management of risk factors can prevent upper extremity dysfunction.