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. 2023 Nov 21;6(1):100310.
doi: 10.1016/j.arrct.2023.100310. eCollection 2024 Mar.

Shoulder Pain in Persons With Tetraplegia and the Association With Force Application During Manual Wheelchair Propulsion

Ursina Arnet  1 , Fransiska M Bossuyt  1 , Benjamin J H Beirens  2 , Wiebe H K de Vries  1
Affiliations

Shoulder Pain in Persons With Tetraplegia and the Association With Force Application During Manual Wheelchair Propulsion

Ursina Arnet et al. Arch Rehabil Res Clin Transl. .

Abstract

Objective: To investigate the association between propulsion biomechanics, including force application and spatio-temporal characteristics, and shoulder pain in persons with tetraplegia.

Design: Cross-sectional, observational study.

Setting: Non-university research institution.

Participants: 16 community dwelling, wheelchair dependent persons with a chronic tetraplegia between C4 and C7, with and without shoulder pain (age, 49.1±11.7 years; 94% men, 23.4±9.5 years past injury).

Interventions: Not applicable.

Main outcome measures: Force application and spatio-temporal characteristics of wheelchair propulsion on a treadmill (0.56 m/s, 10W and 0.83 m/s, 15W). Participants were stratified in groups with low, moderate, and high pain based on their Wheelchair User Shoulder Pain Index (WUSPI) score on the day of measurement.

Results: The mixed-effect multilevel analysis showed that wheelchair users with high levels of shoulder pain applied propulsion force more effectively (and with a lower medial component) and over a longer push angle, thus shortening the recovery time as compared with persons with low or moderate levels of shoulder pain.

Conclusions: In contrast with previous results from persons with a paraplegia, persons with tetraplegia and high levels of shoulder pain propel their wheelchair more optimal with regard to risk factors for shoulder pain. Our results therefore affirm that there is a different interaction of shoulder pain and propulsion biomechanics in persons with a tetraplegia which should be considered when further analyzing risk factors for shoulder pain in wheelchair users or applying literature results to different patient populations.

Keywords: Rehabilitation; Shoulder pain; Spinal cord injury; Tetraplegia; Wheelchair.

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Figures

Fig 1
Fig 1
Total force for the 2 conditions: 0.56 m/s, 10W, and 0.83 m/s, 15W. Data represent mean values cycle normalized to 101 points, stratified by the 3 pain groups: LPG, MPG, and HPG.
See this image and copyright information in PMC

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