Original articleEffect of Shoulder Pain on Shoulder Kinematics During Weight-Bearing Tasks in Persons With Spinal Cord Injury
Section snippets
Participants
Subjects with (n=23) and without (n=20) shoulder pain were recruited through local clinics and SCI/D support groups, resulting in a sample of convenience (table 1). Sample size was based on a power analysis to detect angular differences of 5° or more with 80% power and moderate effect size (0.6).23, 31 All subjects signed institutional-approved informed consent documents.
Inclusion criteria were as follows: 21 to 65 years of age; at least 1 year after SCI/D (complete or incomplete paraplegia, or
Results
Significant differences were found between no-pain and pain groups for the WUSPI score (P<.0003), age (P=.006), and years since injury (P=.018) and are reported in table 1. Significant covariates used in the analysis are presented in table 2.
Discussion
The primary study objective was to assess whether shoulder kinematics differed between individuals with SCI/D with and without shoulder pain. Groups were identified through clinical examination, and the WUSPI scores verified their distinction (2.5±3.7 no-pain group, 43.8±26.9 pain group; P<.0003). In addition to the differences in WUSPI scores, the pain group was older and had been injured for a longer duration than the no-pain group. Of the scapular and glenohumeral kinematics variables
Conclusions
Key findings showed greater scapular upward rotation for the pain group during transfers. Whether indicating a compensatory mechanism to avoid pain, or rotator cuff pathology is not known. The pain group also demonstrated increased scapular anterior tilt during the lift-pivot phase of the transfer in the trailing arm. Potentially detrimental scapular and glenohumeral kinematics (magnitude and direction) found in both groups during the lift and hold phases of the transfer and weight-relief raise
References (58)
- et al.
Shoulder pain in wheelchair users with tetraplegia and paraplegia
Arch Phys Med Rehabil
(1999) - et al.
Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement
Clin Biomech
(2005) - et al.
Paraplegia and the shoulder
Phys Med Rehabil Clin N Am
(2004) - et al.
Functional activity characteristics of individuals with shoulder dysfunctions
J Electromyogr Kinesiol
(2005) - et al.
Comparison of scapular kinematics between elevation and lowering of the arm in the scapular plane
Clin Biomech
(2002) - et al.
Scapular behavior in shoulder impingement syndrome
Arch Phys Med Rehabil
(2002) - et al.
In vivo measurements of subacromial impingement: substantial compression develops in abduction with larger internal rotation
Clin Biomech
(2006) - et al.
Three-dimensional shoulder kinematics during a pressure relief technique and wheelchair transfer
Arch Phys Med Rehabil
(2003) - et al.
Scapular kinematics and associated impingement risk in manual wheelchair users during propulsion and a weight relief lift
Clin Biomech
(2011) - et al.
Shoulder demands in manual wheelchair users across a spectrum of activities
J Electromyogr Kinesiol
(2010)
Load on the shoulder complex during wheelchair propulsion and weight relief lifting
Clin Biomech
ISB recommendations on definitions of joint coordinate systems of various joints for the reporting of human joint motion—part II: shoulder, elbow, wrist and hand
J Biomech
Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo
J Shoulder Elbow Surg
Scapular kinematics: effects of altering the Euler angle sequence of rotations
J Biomech
Contact forces in subacromial space: effects of scapular orientation
J Shoulder Elbow Surg
Radiologic measurement of superior displacement of the humeral head in the impingement syndrome
J Shoulder Elbow Surg
Suprascapular nerve block disrupts the normal pattern of scapular kinematics
Clin Biomech
Mechanical load on the upper extremity during wheelchair activities
Arch Phys Med Rehabil
In vivo measurement of subacromial space width during shoulder elevation: technique and preliminary results in patients following unilateral rotator cuff repair
Clin Biomech
Upper limb pain in a national sample of veterans with paraplegia
J Spinal Cord Med
The weight-bearing shoulder: the impingement syndrome in paraplegics
J Bone Joint Surg Am
Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users
Spinal Cord
Shoulder pain and functional disability in spinal cord injury patients
Clin Orthop Relat Res
Shoulder pain in persons with thoracic spinal cord injury: prevalence and characteristics
J Rehabil Med
Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users
Spinal Cord
Upper extremity pain after spinal cord injury
Spinal Cord
Upper limb function in persons with long term paraplegia and implications for independence: part I
Paraplegia
Prevalence and impact of wrist and shoulder pain in patients with spinal cord injury
J Spinal Cord Med
Clinical trial of exercise for shoulder pain in chronic spinal injury
Phys Ther
Cited by (0)
Supported by the National Institutes of Health (grant no. R15HD41379-01) and the Spinal Cord Research Foundation (grant no. 2251-01).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Jun 15, 2012, at www.archives-pmr.org.