Article

Shoulder joint pain is a frequent secondary complaint for people
following spinal cord injury (SCI). The purpose of this study was to
determine predictors of shoulder joint pain in people with paraplegia. METHODS/ DESIGN: A 3-year longitudinal study was conducted. Participants were
people with paraplegia who used a manual wheelchair for at least 50% of their
mobility and were asymptomatic for shoulder pain at study entry. Participants
were classified as having developed shoulder pain if they experienced an increase
of >/=10 points on the Wheelchair User's Shoulder Pain Index in the 3-year
follow-up period. Measurements of maximal isometric shoulder torques were
collected at study entry (baseline), 18 months, and 3 years. Daily activity was
measured using a wheelchair odometer, and self-reported daily transfer and raise
frequency data were collected by telephone every 6 weeks. RESULTS: Two hundred
twenty-three participants were enrolled in the study; 39.8% developed shoulder
pain over the 3-year follow-up period. Demographic variables and higher activity
levels were not associated with shoulder pain onset. Baseline maximal isometric
torque (normalized by body weight) in all shoulder muscle groups was 10% to 15%
lower in participants who developed shoulder pain compared with those who
remained pain-free. Lower shoulder adduction torque was a significant predictor
of shoulder pain development (log-likelihood test=11.38), but the model explained
only 7.5% of shoulder pain onset and consequently is of limited clinical utility.
LIMITATIONS: Time since SCI varied widely among participants, and transfer and
raise activity was measured by participant recall. CONCLUSIONS: Participants who
developed shoulder pain had decreased muscle strength, particularly in the
shoulder adductors, and lower levels of physical activity prior to the onset of
shoulder pain. Neither factor was a strong predictor of shoulder pain onset.
CI - (c) 2015 American Physical Therapy Association.

Langue : ANGLAIS