Article

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 eta(2)=.062, P<.05) and less pain during transfers (partial eta(2)=.049,
P<.10). Greater age was the strongest predictor of greater pathology (USPRS
total: partial eta(2)=.225, supraspinatus grade: partial eta(2)=.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: R(2)=.422, P<.05; middle weight: R(2)=.200, P<.01), while
those with higher weight showed little change with technique (R(2)=.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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS