Abstract
Objectives
To determine (1) agreement of musculoskeletal ultrasound (MSK-US) findings of shoulder
pathology and related shoulder special test results in individuals with varied durations
of manual wheelchair (MWC) use after spinal cord injury (SCI); and (2) whether shoulder
musculoskeletal impairments, per MSK-US and clinical examination, differed in individuals
with SCI and varying durations of MWC use.
Design
Cross-sectional cohort study.
Setting
Laboratory setting.
Participants
Adult volunteers (N=23) with SCI who used an MWC for community mobility. Individuals
were stratified into 3 groups based on duration of MWC use: <5 years, 5 to 15 years,
and >15 years.
Interventions
Not applicable.
Main Outcome Measures
Special tests for shoulder impingement and bicipital tendonitis were performed. Bilateral
shoulder MSK-US was performed, with the Ultrasound Shoulder Pathology Rating Scale
(USPRS) quantifying biceps tendon, supraspinatus tendon, and greater tuberosity cortical
surface impairments.
Results
No agreement was found between MSK-US and related special tests. Special tests failed
to identify impairment in 33.3% to 100% of those identified on MSK-US. The total USPRS
score was highest in those with >15 years' MWC use. A higher proportion of dynamic
impingement (supraspinatus and biceps) was found in those with >15 years' MWC use,
with other MSK-US items having moderate effect sizes among duration-use groups.
Conclusions
MSK-US identified shoulder impairments more frequently than commonly used special
tests. A significant increase in the presence of MSK-US shoulder impairments was identified
in the longest-duration group. This was not the case for special tests or pain. MSK-US
is an easily administered, low-cost, noninvasive method for determining shoulder impairments
and should be used in routine screening of individuals who use an MWC after SCI.
Keywords
List of abbreviations:
BMI (body mass index), MSK-US (musculoskeletal ultrasound), MWC (manual wheelchair), PASIPD (Physical Activity Scale for Individuals with Physical Disabilities), SCI (spinal cord injury), UE (upper extremity), USPRS (Ultrasound Shoulder Pathology Rating Scale), WUSPI (Wheelchair Users 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: January 12, 2018
Footnotes
Supported by an internal research grant from the College of Nursing and Health Professions, Drexel University.
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
