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

• Published in: Archives of rehabilitation research and clinical translation 2024-03, Vol.6 (1), p.100310-100310, Article 100310
• Main Authors: Arnet, Ursina, Bossuyt, Fransiska M., Beirens, Benjamin J.H., de Vries, Wiebe H.K.
• Format: Article
• Language: English
• Subjects: Original Research; Rehabilitation; Shoulder pain; Spinal cord injury; Tetraplegia; Wheelchair
• ISSN: 2590-1095; 2590-1095
• DOI: 10.1016/j.arrct.2023.100310

To investigate the association between propulsion biomechanics, including force application and spatio-temporal characteristics, and shoulder pain in persons with tetraplegia. Cross-sectional, observational study. Non-university research institution. 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). Not applicable. 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. 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. 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.