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Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study

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Abstract

Introduction

Shoulder pain in spinal cord injury (SCI) is common due to the repetition of the wheelchair propulsion and the increased intra-articular pressure during transfers. Known risk factors for the onset of shoulder pain are age and level of SCI. Aims of this study were to assess how body mass index affects the onset of shoulder pain and to evaluate the relationship between the age at the moment of SCI and the number of years between SCI and the onset of shoulder pain.

Methods

A retrospective study was performed including subjects with SCI between C5 and S3. Excluding criteria were spina bifida and subjects not using manual wheelchair or presenting with shoulder pain before SCI. Patients in the two spinal cord units were reviewed with a self-made questionnaire, and patients were also enrolled during sport events. Age at the moment of SCI, current age and number of years between SCI and the onset of shoulder pain were recorded.

Results

Ninety-six patients were enrolled: 77 men and 19 women; 46.4 % reported shoulder pain. Overweight patients who do more than 12 transfers per day showed an increased incidence of shoulder pain (p = 0.0434). A linear regression showed a significant relationship between the age of the subject at the moment of SCI and the number of years between the SCI and the onset of pain.

Conclusion

Our study confirms that age and level of SCI are risk factors for shoulder pain, but we demonstrated also that overweight patients who do more than 12 transfers per day have higher chances of having shoulder pain.

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References

  1. Alm M, Saraste H, Norrbrink C (2008) Shoulder pain in persons with thoracic spinal cord injury: prevalence and characteristics. J Rehabil Med 40(4):277–283

    Article  PubMed  Google Scholar 

  2. Finley MA, Rasch EK, Keyser RE, Rodgers MM (2004) The biomechanics of wheelchair propulsion in individuals with and without upper-limb impairment. J Rehabil Res Dev 41(3B):385–395

    Article  PubMed  Google Scholar 

  3. Fullerton HD, Borckardt JJ, Alfano AP (2003) Shoulder pain: a comparison of wheelchair athletes and nonathletic wheelchair users. Med Sci Sports Exerc 35(12):1958–1961

    Article  PubMed  Google Scholar 

  4. Hastings J, Goldstein B (2004) Paraplegia and the shoulder. Phys Med Rehabil Clin N Am 15(3):699–718

    Article  Google Scholar 

  5. Pentland WE, Twomey LT (1994) Upper limb function in persons with long term paraplegia and implications for independence: part I. Paraplegia 32(4):211–218

    Article  CAS  PubMed  Google Scholar 

  6. Subbarao JV, Klopfstein J, Turpin R (1995) Prevalence and impact of wrist and shoulder pain in patients with spinal cord injury. J Spinal Cord Med 18(1):9–13

    CAS  PubMed  Google Scholar 

  7. Bayley JC, Cochran TP, Sledge CB (1987) The weight-bearing shoulder. The impingement syndrome in paraplegics. J Bone Joint Surg Am 69(5):676–678

    CAS  PubMed  Google Scholar 

  8. Gagnon D (2008) Comparison of peak shoulder and elbow mechanical loads during weight-relief lifts and sitting pivot transfers among manual wheelchair users with spinal cord injury. J Rehabil Res Dev 45(6):863–874

    Article  PubMed  Google Scholar 

  9. Porcellini G (2011) La patologia di spalla e gomito negli sport olimpici e paralimpici (TIMEO Ed.). ISBN 9788897162155

  10. Curtis KA, Drysdale GA, Lanza RD, Kolber M, Vitolo RS, West R (1999) Shoulder pain in wheelchair users with tetraplegia and paraplegia. Arch Phys Med Rehabil 80(4):453–457

    Article  CAS  PubMed  Google Scholar 

  11. Gil-Agudo A, Del Ama-Espinosa A, Perez-Rizo E, Perez-Nombela S, Pablo Rodriguez-Rodriguez L (2010) Upper limb joint kinetics during manual wheelchair propulsion in patients with different levels of spinal cord injury. J Biomech 43(13):2508–2515

    Article  PubMed  Google Scholar 

  12. Akbar M, Brunner M, Balean G, Grieser T, Bruckner T, Loew M, Raiss P (2012) Etiology of rotator cuff tears in paraplegic patients: a case–control study. J Shoulder Elbow Surg 21(1):23–28

    Article  PubMed  Google Scholar 

  13. Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA (2006) The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 88(8):1699–1704

    Article  PubMed  Google Scholar 

  14. Lal S (1998) Premature degenerative shoulder changes in spinal cord injury patients. Spinal Cord 36(3):186–189

    Article  CAS  PubMed  Google Scholar 

  15. Medina GI, Nascimento FB, Rimkus CM, Zoppi Filho A, Cliquet A Jr (2011) Clinical and radiographic evaluation of the shoulder of spinal cord injured patients undergoing rehabilitation program. Spinal Cord 49(10):1055–1061

    Article  CAS  PubMed  Google Scholar 

  16. Sinnott KA, Milburn P, McNaughton H (2000) Factors associated with thoracic spinal cord injury, lesion level and rotator cuff disorders. Spinal Cord 38(12):748–753

    Article  CAS  PubMed  Google Scholar 

  17. Finley MA, Rodgers MM (2004) Prevalence and identification of shoulder pathology in athletic and nonathletic wheelchair users with shoulder pain: a pilot study. J Rehabil Res Dev 41(3B):395–402

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology Surgery, San Luigi Hospital, University of Torino, Turin, Italy

    G. Ferrero, E. Mijno, N. Ratto & A. Arpaia

  2. Department of Orthopaedics, Traumatology and Rehabilitation, AO Città della Salute e della Scienza, CTO Hospital, Turin, Italy

    M. V. Actis

  3. Spinal Unit, Department of Rehabilitation Medicine, Physical Medicine and Rehabilitation Institute, Udine, Italy

    A. Zampa

  4. Department of Orthopaedics and Traumatology, C.T.O.-Maria Adelaide Hospital, University of Torino, Turin, Italy

    A. Massè

Authors
  1. G. Ferrero
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  2. E. Mijno
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  3. M. V. Actis
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  4. A. Zampa
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  5. N. Ratto
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  6. A. Arpaia
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  7. A. Massè
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Corresponding author

Correspondence to G. Ferrero.

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Ferrero, G., Mijno, E., Actis, M.V. et al. Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study. Musculoskelet Surg 99 (Suppl 1), 53–56 (2015). https://doi.org/10.1007/s12306-015-0363-2

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  • DOI: https://doi.org/10.1007/s12306-015-0363-2

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