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086 The relationship between shoulder pain, physical exam findings, and structural pathology in elite wheelchair athletes
  1. Cheri Blauwet1,8,
  2. Wayne Derman2,8,
  3. Nick Webborn3,8,
  4. Dylan Morrissey4,
  5. Julian Chakraverty5,
  6. Paul Martin6,
  7. Guzel Idrisova7,8
  1. 1Harvard Medical School/Spaulding Rehabilitation Hospital, Boston, USA
  2. 2University of Stellenbosch/South Africa IOC Injury and Illness Prevention Reserach Center, Stellenbosch, South Africa
  3. 3University of Brighton, Brighton, UK
  4. 4Queen Mary Unveristy of London, London, UK
  5. 5University Hospitals of Bristol, Bristol, UK
  6. 6English Institute of Sport, Manchester, UK
  7. 7Russian Paralympic Committee, Moscow, Russian Federation
  8. 8International Paralympic Committee, Bonn, Germany


Background Although athletes who are wheelchair users for both daily activity and sport participation are at high risk for shoulder injuries, little is known regarding the characteristics of shoulder injury in this population.

Objective To determine the relationship between shoulder symptoms (SS), physical exam findings (PEF), and structural pathology (SP) in elite wheelchair athletes competing in athletics and powerlifting

Design Cross-sectional study.

Setting Three international competitions.

Participants 80 elite wheelchair athletes competing in track (n=40), field (n=19) and powerlifting (n=20) who also used a manual wheelchair for daily mobility.

Assessment of Risk Factors A senior sports physiotherapist and musculoskeletal radiologist obtained measures of SS, PEF, and MSK ultrasound (MSK-U) findings. Relationships between measures and for sub-groups by sporting discipline were calculated. Age, duration of disability, and disability type were evaluated as independent risk factors for pain or structural pathology.

Main Outcome Measurements The Wheelchair Users Shoulder Pain Index (WUSPI), Physical Examination of the Shoulder Scale (PESS), and the ultrasound Shoulder Pathology Rating Scale (USPRS)

Results A total of 51 of 80 athletes reported dominant shoulder pain. PESS scores were 7.4 ± 6.7, WUSPI 22.3 ± 26.9 and USPRS 5.2 ± 4.0. A positive main effect was found for pain history on PESS (F1,154 = 9.57 p = 0.002, ηp 2 = 0.06) but no interaction with athlete sub-group (F2,154 = 1.90 p = 0.15, ηp 2 = 0.02). There were no USPRS score differences between sub groups, but track athletes had lower WUSPI scores and lower PESS scores. The WUSPI and PESS which were strongly correlated (0.71), while the USPRS which did not correlate with either the PESS (0.21) or WUSPI (0.20).

Conclusions Elite wheelchair athletes have a high prevalence of MSK-U pathology with low-moderate levels of SS and PEF. MSK-U findings do not correlate with SS or PEF. These findings are an important step to educate the development of targeted preventative measures.

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