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Kirby RL, Parker K, Poon E, Smith C, Osmond D, Ladouceur M, Haworth VS, Theriault CJ, Sandila N. Effect of travel direction and wheelchair position on the ease of a caregiver getting an occupied wheelchair across a soft surface: a randomized crossover trial. Disabil Rehabil Assist Technol 2024; 19:1298-1306. [PMID: 36695416 DOI: 10.1080/17483107.2023.2170476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/09/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE To test the hypotheses that, in comparison with pushing an occupied upright manual wheelchair forward, pulling backward on the push-handles improves the objective and subjective ease with which a caregiver can get the wheelchair across a soft surface (e.g., grass, mud, sand, gravel); and the ease with which a caregiver can get the wheelchair across a soft surface improves if the wheelchair is tipped back into the wheelie position. METHODS We used a randomized crossover trial with within-participant comparisons to study 32 able-bodied pairs of simulated caregivers and wheelchair occupants. The caregiving participants moved an occupied manual wheelchair 5 m across a soft surface (7.5-cm-thick gym mats) under four conditions (upright-forward, upright-backward, wheelie-forward and wheelie-backward) in random order. The main outcome measure was time (to the nearest 0.1 s) and the main secondary measure was the ease of performance (5-point Likert scale). RESULTS The upright-backward condition was the fastest (p < 0.05) and had the highest ease-of-performance scores. In the forward direction, there was no statistically significant difference in the time required between the upright and wheelie positions, but the wheelie position was considered easier. CONCLUSIONS Although further study is needed, our findings suggest that caregivers should pull rather than push occupied wheelchairs across soft surfaces. In the forward direction, caregivers may find the wheelie position easier than the upright condition. These techniques have the potential to both improve the effectiveness of and reduce injuries to caregivers. Clinical Trial Registration Number: NCT04998539.
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Affiliation(s)
- R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Kim Parker
- Assistive Technology Program, Nova Scotia Health, Halifax, NS, Canada
| | - Eric Poon
- Class of 2023, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Cher Smith
- Department of Occupational Therapy, Nova Scotia Health, Halifax, NS, Canada
| | - Dee Osmond
- Department of Occupational Therapy, Nova Scotia Health, Halifax, NS, Canada
| | - Michel Ladouceur
- Kinesiology, School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | | | | | - Navjot Sandila
- Research Methods Unit, Nova Scotia Health, Halifax, NS, Canada
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Deger GU, Davulcu CD, Karaismailoglu B, Palamar D, Guven MF. Are acromiohumeral distance measurements on conventional radiographs reliable? A prospective study of inter-method agreement with ultrasonography, and assessment of observer variability. Jt Dis Relat Surg 2024; 35:62-71. [PMID: 38108167 PMCID: PMC10746906 DOI: 10.52312/jdrs.2023.1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/25/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES This study aims to investigate the reliability of acromiohumeral distance (AHD) measurements using conventional radiographs and to compare non-standardized and standardized radiographs with intra-/interobserver reliability measurements. PATIENTS AND METHODS Between February 2021 and January 2022, a total of 110 shoulders of 55 patients (25 males, 30 females; mean age: 49.7±12.6 years; range, 25 to 77 years) were included. Radiographs were taken in four different positions: primarily shoulder anteroposterior (AP), true AP, standardized true AP, and standardized outlet views. The AHD was measured by three orthopedists. A prospective ultrasonography (US) evaluation was performed by an experienced physiatrist, and the relationship between US and radiographic measurements was evaluated. The intra- and interobserver reliability of radiographic measurements was assessed. RESULTS On the standardized true AP view measurements, all observers showed a moderate to good agreement with US measurements (intraclass correlation coefficients [ICC]: 0.68-0.75). There was no significant difference between the AHD measurements of the senior orthopedist on standardized true AP and outlet views, and the US measurements. The intraobserver agreement of US measurements was excellent (ICC: 0.98, 95% confidence interval [CI]: 0.98-0.99), and the intraobserver agreement level of measurements on radiographs were good to excellent with a wide range of ICC values (ICC: 0.79-0.97). Interobserver reliability was the highest on the standardized outlet view, with an ICC of 0.91 and 0.88 in two measurement times. Interobserver reliability of other measurements were good with ICC values ranging from 0.82 to 0.88. CONCLUSION The AHD measurements on radiographs are compatible with US measurements within up to 2 mm difference if standardization is ensured. Also, measurements on standardized views have a superior consistency with lower standard error of measurement and minimal detectable change values. Therefore, we recommend using standardized true shoulder AP and standardized outlet radiographs in clinical practice and studies, as these are the most accurate in demonstrating true AHD.
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Affiliation(s)
| | | | | | | | - Mehmet Fatih Guven
- Department of Orthopedics and Traumatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, 34098 Fatih, Istanbul, Türkiye
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Skedros JG, Cronin JT, Finlinson ED, Langston TD, Adondakis MG. Manual wheelchair use leads to a series of failed shoulder replacements: A case report and literature review. Clin Case Rep 2022; 10:e06374. [PMID: 36188047 PMCID: PMC9508804 DOI: 10.1002/ccr3.6374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/12/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- John G. Skedros
- Department of Orthopaedic Surgery The University of Utah Salt Lake City Utah USA
- Utah Orthopaedic Specialists Salt Lake City Utah USA
- Intermountain Medical Center Salt Lake City Utah USA
| | | | | | - Tanner D. Langston
- Department of Radiology West Virginia University Morgantown West Virginia USA
| | - Micheal G. Adondakis
- Department of Radiology Beth Israel Deaconess Medical Center Boston Massachusetts USA
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Soo Hoo JA, Kim H, Fram J, Lin YS, Page C, Easthausen I, Jayabalan P. Shoulder pain and ultrasound findings: A comparison study of wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users. PM R 2022; 14:551-560. [PMID: 34028204 PMCID: PMC9444331 DOI: 10.1002/pmrj.12648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/08/2021] [Accepted: 05/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Shoulder pain is one of the most common musculoskeletal concerns in manual wheelchair users including among athletes. However, there is a paucity of research characterizing both shoulder pain and shoulder pathology in this population. OBJECTIVE To characterize and compare the prevalence of current shoulder pain and ultrasound metrics of shoulder pathology between wheelchair athletes, nonathletic wheelchair users, and nonwheelchair users. DESIGN Cross-sectional. SETTING Chicago-area adaptive sport teams/programs and musculoskeletal clinics. PARTICIPANTS Thirty-four wheelchair athletes, six nonathletic wheelchair users, and 12 nonwheelchair users. METHODS Self-reported shoulder pain was assessed by questionnaire and Wheelchair User Shoulder Pain Index (WUSPI). Shoulder physiology and pathology were assessed by physical and ultrasound evaluation of both shoulders by a sports medicine physician. MAIN OUTCOME MEASURES Questionnaire outcomes: Prevalence of current shoulder pain, total WUSPI score. Physical examination outcomes: total Physical Examination of Shoulder Scale (PESS) score. Sonographic outcomes: Acromiohumeral distance (AHD) and presence of shoulder pathology. RESULTS The majority of wheelchair athletes (68%) and nonathletic wheelchair users (67%) experienced shoulder pain since using a manual wheelchair. Wheelchair basketball players had a mean WUPSI score of 17.2 (SD = 21.8), and athletes participating in handcycling, sled hockey, and quad rugby had mean scores of 4.91 (SD = 8.32), 7.76 (SD = 13.1), and 4.29 (SD = 7.75), respectively. Shoulder pathology was observed in 14 of 31 (45%) wheelchair athletes and 4 of 6 (67%) nonathletic wheelchair users (p = .41). CONCLUSIONS Although wheelchair use is a risk factor for shoulder pain, participation in amateur wheelchair sports may not be associated with increased risk of shoulder pain. It is possible that overhead sports such as wheelchair basketball may define a unique high-risk group. Further study is needed to examine this relationship and to determine whether there are differences between specific wheelchair sports.
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Affiliation(s)
- Jennifer A. Soo Hoo
- Division of Rehabilitation Medicine, Weill Cornell Medicine/NYP, New York, New York, USA
| | - Hyungtaek Kim
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Julia Fram
- Shirley Ryan Ability Lab, Chicago, Illinois, USA,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yen-Sheng Lin
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA,Department of Orthopedic Surgery, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Imaani Easthausen
- Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, New York, USA
| | - Prakash Jayabalan
- Shirley Ryan Ability Lab, Chicago, Illinois, USA,Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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Arnet U, Boninger ML, Cools A, Bossuyt FM. Effect of Fatiguing Wheelchair Propulsion and Weight Relief Lifts on Subacromial Space in Wheelchair Users. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:849629. [PMID: 36189050 PMCID: PMC9397688 DOI: 10.3389/fresc.2022.849629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022]
Abstract
ObjectiveThis study aimed to identify targets of intervention for reducing shoulder pain in wheelchair users with spinal cord injury (SCI) by (1) examining changes in subacromial space [acromiohumeral distance (AHD) and occupation ratio (OccRatio)] with fatiguing wheelchair propulsion, and different loading conditions [unloaded position vs. weight relief lifts (WRL)]; (2) associating these changes with wheelchair user capacity, as well as (3) identifying subject characteristics associated with subacromial space, such as sex, lesion level, time since injury, body mass index and impaired shoulder range of motion.MethodsFifty manual wheelchair users with SCI [11 females, age = 50.5 (9.7) years, time since injury = 26.2 (11.4) years] participated in this quasi-experimental one-group pretest-posttest study. Ultrasound images were used to define AHD during an unloaded position, and during personal and instructed WRL before and after fatiguing wheelchair propulsion. Furthermore, supraspinatus and biceps thickness defined from ultrasound images were used to calculate OccRatios. Wheelchair user capacity was quantified as functional strength (maximum resultant force reached during maximum isometric forward push) and anaerobic work capacity (highest power output reached during 15-m sprint test). Multilevel mixed-effects linear regression analyses controlling for between subject variability and covariables were performed to address the research questions.ResultsAHD was significantly smaller during personal WRL (p < 0.001) and instructed WRL (p = 0.009, AHD both 11.5 mm) compared to the unloaded position (11.9 mm). A higher wheelchair user capacity (higher anaerobic work capacity) reduced the impact of WRL on AHD decrease. The fatiguing wheelchair propulsion had no effect on AHD (p = 0.570) and on OccRatio of supraspinatus (p = 0.404) and biceps (p = 0.448). Subject characteristics related to a larger subacromial space were lower lesion level, shorter time since injury, impaired external rotation, a lower body mass index and a higher anaerobic work capacity.ConclusionThis study showed a significant reduction in AHD during WRL with no effect of fatiguing wheelchair propulsion on the subacromial space in wheelchair users with SCI. A higher anaerobic work capacity was beneficial in stabilizing the shoulder during WRL. Our findings may assist clinicians in designing a shoulder injury prevention program.
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Affiliation(s)
- Ursina Arnet
- Shoulder Health and Mobility Group, Swiss Paraplegic Research, Nottwil, Switzerland
- *Correspondence: Ursina Arnet
| | - Michael L. Boninger
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ann Cools
- Department of Rehabilitation Sciences and Physiotherapy, University of Ghent, Ghent, Belgium
| | - Fransiska M. Bossuyt
- Shoulder Health and Mobility Group, Swiss Paraplegic Research, Nottwil, Switzerland
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
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Haubert LL, Mulroy SJ, Eberly VJ, Gronley JK, Hatchett PE, Conners SG. Shoulder Pain Prevention Program for Manual Wheelchair Users With Paraplegia: A Randomized Clinical Trial. Top Spinal Cord Inj Rehabil 2021; 27:40-52. [PMID: 34866887 PMCID: PMC8604502 DOI: 10.46292/sci20-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives: To compare prevalence of shoulder pain (SP) onset over 3 years for individuals with paraplegia from spinal cord injury who participate in one of two shoulder pain prevention program (SPPP) formats with that of a similar population without intervention, and to compare exercise adherence between two SPPP formats. Methods: The randomized clinical trial (compared to historical controls) included a volunteer sample of 100 individuals without SP at study entry. Eighty-seven participants returned for assessments at 18 and 36 months after study entry. Control group included 220 volunteers from a 3-year observational study with identical inclusion criteria. SPPPs included shoulder home exercises and recommendations to improve mobility techniques that are effective in reducing existing SP in this population. Participants were randomly assigned to receive either one instruction session and a refresher session 4 weeks later with a physical therapist or a 4-week series of 2-hour group classes taught by a physical therapist and peer mentor. Prevalence of SP onset at 18 and 36 months and self-reported average weekly exercise frequency were the main outcome measures. Results: SP onset was identical in the two SPPPs but was significantly lower at 18 and 36 months in both groups (11% and 24%) compared to controls (27% and 40%, p < .05). Self-reported average weekly exercise frequency was similar between intervention groups but was significantly lower during the first 4 months in participants who developed SP compared to those without pain (2.12 ± 1.0 vs. 3.01 ± 1.13, p < .05). Conclusion: SPPPs reduced SP onset prevalence regardless of instruction format. Exercise adherence was important to the outcome of shoulder pain.
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Affiliation(s)
| | - Sara J. Mulroy
- Rancho Los Amigos National Rehabilitation Center, Downey, California
| | - Valerie J. Eberly
- Rancho Los Amigos National Rehabilitation Center, Downey, California
| | - JoAnne K. Gronley
- Rancho Los Amigos National Rehabilitation Center, Downey, California
| | | | - Sandy G. Conners
- Rancho Los Amigos National Rehabilitation Center, Downey, California
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Mashola MK, Korkie E, Mothabeng DJ. 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; 11:e044152. [PMID: 33408217 PMCID: PMC7789463 DOI: 10.1136/bmjopen-2020-044152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Approximately 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 ANALYSIS Community-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 DISSEMINATION Approval 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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Affiliation(s)
- Mokgadi Kholofelo Mashola
- Department of Physiotherapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa
- Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa
| | - Diphale Joyce Mothabeng
- Department of Physiotherapy, School of Healthcare Sciences, University of Pretoria, Pretoria, South Africa
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Park SW, Chen YT, Thompson L, Kjoenoe A, Juul-Kristensen B, Cavalheri V, McKenna L. No relationship between the acromiohumeral distance and pain in adults with subacromial pain syndrome: a systematic review and meta-analysis. Sci Rep 2020; 10:20611. [PMID: 33244115 PMCID: PMC7693267 DOI: 10.1038/s41598-020-76704-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023] Open
Abstract
To determine whether subacromial space (i.e. acromiohumeral distance; AHD, and/or occupation ratio percentage) differs between people with subacromial pain syndrome (SAPS) and those without. To investigate whether there is a correlation between subacromial space and pain or disability in adults with SAPS and whether temporal changes in pain or disability are accompanied by changes in subacromial space. Systematic review and meta-analysis. Fifteen studies with a total of 775 participants were included. Twelve studies were of high quality and three studies were of moderate quality using the modified Black and Downs checklist. There was no between group difference in AHD in neutral shoulder position (mean difference [95% CI] 0.28 [-0.13 to 0.69] mm), shoulder abduction at 45° (-0.02 [-0.99 to 0.96] mm) or 60° (-0.20 [-0.61 to 0.20] mm). Compared to the control group, a greater occupation ratio in neutral shoulder position was demonstrated in participants with SAPS (5.14 [1.87 to 8.4] %). There was no consistent pattern regarding the correlation between AHD and pain or disability in participants with SAPS, and no consistent increase in subacromial space with improvement in pain or disability over time. The results suggest that surgical (e.g. sub-acromial decompression) and non-surgical (e.g. manual therapy, taping, stretching and strengthening) management of subacromial pain syndrome should not focus solely on addressing a potential decrease in subacromial space, but also on the importance of other biopsychosocial factors.
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Affiliation(s)
- Soo Whan Park
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Yuan Tai Chen
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Lindsay Thompson
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Andreas Kjoenoe
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Birgit Juul-Kristensen
- Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
| | - Vinicius Cavalheri
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Australia
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Mozingo JD, Akbari-Shandiz M, Murthy NS, Van Straaten MG, Schueler BA, Holmes DR, McCollough CH, Zhao KD. Shoulder mechanical impingement risk associated with manual wheelchair tasks in individuals with spinal cord injury. Clin Biomech (Bristol, Avon) 2020; 71:221-229. [PMID: 32035338 PMCID: PMC7050284 DOI: 10.1016/j.clinbiomech.2019.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 10/11/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Most individuals with spinal cord injury who use manual wheelchairs experience shoulder pain related to wheelchair use, potentially in part from mechanical impingement of soft tissue structures within the subacromial space. There is evidence suggesting that scapula and humerus motion during certain wheelchair tasks occurs in directions that may reduce the subacromial space, but it hasn't been thoroughly characterized in this context. METHODS Shoulder motion was imaged and quantified during scapular plane elevation with/without handheld load, propulsion with/without added resistance, sideways lean, and weight-relief raise in ten manual wheelchair users with spinal cord injury using biplane fluoroscopy and computed tomography. For each position, minimum distance between rotator cuff tendon insertions (infraspinatus, subscapularis, supraspinatus) and the coracoacromial arch was determined. Tendon thickness was measured with ultrasound, and impingement risk scores were defined for each task based on frequency and amount of tendon compression. FINDINGS Periods of impingement were identified during scapular plane elevation and propulsion but not during pressure reliefs in most participants. There was a significant effect of activity on impingement risk scores (P < 0.0001), with greatest impingement risk during scapular plane elevation followed by propulsion. Impingement risk scores were not significantly different between scapular plane elevation loading conditions (P = 0.202) or propulsion resistances (P = 0.223). The infraspinatus and supraspinatus tendons were both susceptible to impingement during scapular plane elevation (by acromion), whereas the supraspinatus was most susceptible during propulsion (by acromion and coracoacromial ligament). INTERPRETATION The occurrence of mechanical impingement during certain manual wheelchair tasks, even without increased load/resistance, demonstrates the importance of kinematics inherent to a task as a determinant of impingement. Frequency of and technique used to complete daily tasks should be carefully considered to reduce impingement risk, which may help preserve shoulder health long-term.
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Affiliation(s)
- Joseph D Mozingo
- Biomedical Engineering and Physiology Graduate Program, Mayo Clinic Graduate School of Biomedical Sciences, USA; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - David R Holmes
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | | | - Kristin D Zhao
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA.
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Risikofaktoren für Rotatorenmanschettenrupturen bei Paraplegikern. DER ORTHOPADE 2018; 47:561-566. [DOI: 10.1007/s00132-018-3546-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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11
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Gil-Agudo A, Mozos MS, Crespo-Ruiz B, del-Ama AJ, Pérez-Rizo E, Segura-Fragoso A, Jiménez-Díaz F. Shoulder kinetics and ultrasonography changes after performing a high-intensity task in spinal cord injury subjects and healthy controls. Spinal Cord 2015; 54:277-82. [PMID: 26282495 DOI: 10.1038/sc.2015.140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/19/2015] [Accepted: 07/03/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN This is a prospective and comparative study between two groups. OBJECTIVES The objective of this study was to compare the changes in shoulder joint forces and their moments, as well as any possible ultrasound changes, when subjects with spinal cord injury (SCI) and healthy controls (CG) undertake a high-intensity manual wheelchair propulsion test. SETTING This study was conducted in an inpatient SCI rehabilitation center. METHODS A group of 22 subjects with SCI at level T2 or below who use a manual wheelchair (MWU), categorized as AIS grade A or B, were compared with a CG of 12 healthy subjects. Subjects in each group performed a high-intensity wheelchair propulsion test. The variables analyzed were shoulder joint forces and the moments at the beginning and at the end of the test. Ultrasound variables before and after the propulsion test were also analyzed. Correlations were also drawn between the ultrasonography and demographic variables. RESULTS In both groups, peak shoulder forces and moments increased after the test in almost all directions. No differences in the ultrasound parameters were found. A greater long-axis biceps tendon thickness (LBTT) was associated with more shoulder pain according to WUSPI or VAS (r=0.428, P<0.05 and r=0.452, P<0.05, respectively). CONCLUSIONS Shoulder joint forces and moments increase after an intense propulsion task. In subjects with SCI, these increases center on forces with less chance of producing subacromial damage. No changes are produced in ultrasonography variables, whereas a poorer clinical and functional evaluation of the shoulder of the MWUs appears to be related to a thicker long-axis biceps tendon.
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Affiliation(s)
- A Gil-Agudo
- Department of Physical Medicine and Rehabilitation, Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, SESCAM, Toledo, Spain
| | - M S Mozos
- Department of Physical Medicine and Rehabilitation, Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, SESCAM, Toledo, Spain
| | - B Crespo-Ruiz
- Department of Physical Medicine and Rehabilitation, Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, SESCAM, Toledo, Spain
| | - A J del-Ama
- Department of Physical Medicine and Rehabilitation, Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, SESCAM, Toledo, Spain
| | - E Pérez-Rizo
- Department of Physical Medicine and Rehabilitation, Biomechanics and Technical Aids Unit, National Hospital for Paraplegics, SESCAM, Toledo, Spain
| | | | - F Jiménez-Díaz
- Faculty of Sport Science, Laboratory of Performance and Sports Rehabilitation, University of Castilla-La Mancha Toledo, Spain
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