Abstract
Objectives
To evaluate how transfer technique and subject characteristics relate to ultrasound
measures of shoulder soft tissue pathology and self-reported shoulder pain during
transfers in a sample of wheelchair users with spinal cord injury (SCI).
Design
Cross-sectional observational study.
Setting
Research laboratory, national and local veterans' wheelchair sporting events.
Participants
A convenience sample of wheelchair users (N=76) with nonprogressive SCI. Participants
were aged >18 years, >1 year postinjury, and could complete repeated independent wheelchair
transfers without the use of their leg muscles.
Interventions
Not applicable.
Main Outcome Measures
Transfer pain items from the Wheelchair User's Shoulder Pain Index; transfer technique
assessed using the Transfer Assessment Instrument (TAI); and shoulder pathology markers
examined using the Ultrasound Shoulder Pathology Rating Scale (USPRS).
Results
Better transfer technique (higher TAI) correlated with less injury (lower USPRS) (partial
η2=.062, P<.05) and less pain during transfers (partial η2=.049, P<.10). Greater age was the strongest predictor of greater pathology (USPRS total:
partial η2=.225, supraspinatus grade: partial η2=.174, P<.01). An interaction between technique and weight was found (P<.10): participants with lower body weights showed a decrease in pathology markers
with better transfer technique (low weight: R2=.422, P<.05; middle weight: R2=.200, P<.01), while those with higher weight showed little change with technique (R2=.018, P>.05).
Conclusions
Participants with better transfer technique exhibited less shoulder pathology and
reported less pain during transfers. The relationship between technique and pathology
was strongest in lower-weight participants. While causation cannot be proven because
of study design, it is possible that using a better transfer technique and optimizing
body weight could reduce the incidence of shoulder pathology and pain.
Keywords
List of abbreviations:
ICC (intraclass correlation coefficient), SCI (spinal cord injury), TAI (Transfer Assessment Instrument), TAI-1 (Transfer Assessment Instrument part 1), USPRS (Ultrasound Shoulder Pathology Rating Scale), WUSPI (Wheelchair User's Shoulder Pain Index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 23, 2016
Footnotes
This material is the result of work supported with resources and the use of facilities at the Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System. The contents of this paper do not represent the views of the Department of Veterans Affairs or the United States Government. This project was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (grant no. H133N110011). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). This material is based on work supported by the National Science Foundation Graduate Research Fellowship (grant no. 1247842). The contents of this publication do not necessarily reflect the view of the National Science Foundation or the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
