The shoulder is the most commonly reported site of musculoskeletal injury in manual wheelchair users. After eight weeks of treatment the patient had improved shoulder and neck rom, pain level, dash and neck pain disability scale scores. Exercise is a feasible, conservative, therapeutic intervention for the treatment of shoulder pain among mwus. The purpose of this study was to examine the reliability and validity of the wheelchair users shoulder pain index wuspi, an instrument. Strategies to thwart further disability from shoulder pain include primary prevention and rehabilitation. Wheelchair users shoulder pain index elderly mobility. Two recent projects of the manual wheelchair research program at mayo clinic have included efforts to address both strategies. Across the 7 studies, the exercise intervention was associated with reduction in shoulder pain that exceeded the estimated minimal detectable change of 5. Difference in presence and severity of shoulder pain, between athlete and nonathletes with sci tetraplegic and paraplegic manual wheelchair user, will be recorded by selfreported wheelchair user. These postures are utilized frequently in lateral transfers. The wheelchair users shoulder pain index macquarie university.
Subjectively perceived neck pain was assessed by a visual analog scale, 16 and the disability was assessed by the modified neck and shoulder pain and disability index 14 and vernon neck disability index. Shoulder pain among rehabilitated spinal cord injured. No indices are currently available which detect difficulties in performing daily activities due to shoulder discomfort in a largely independent population of wheelchair users. Wheelchair users shoulder pain index rehabmeasures database. To determine the effectiveness of acupuncture and trager psychophysical integration a form of manual therapy in decreasing chronic shoulder pain in wheelchair users with spinal cord injury sci. Participants also completed the wheelchair user s shoulder pain index wuspi. Additional studies are needed to differentiate techniques for the reduction of shoulder pain, to determine the most effective duration of intervention, and to estimate. According to the authors, webbased training may be an efficient way to give wheelchair users information about proper transfer techniques and therefore reduce risk of injury or chronic pain in wrists, arms, and shoulders. The wuspi is a selfreport measure of shoulder pain in wheelchair users during functional activities. Shoulder pain and disability index spadi total score, pain subscale, disability subscale and quick disability of the arm, shoulder and hand quickdash. Noncontrast clinical shoulder mr images were performed on a sample of 10 mwc users with sci average years of mwc use 14 years. Evidence portfolio chronic conditions subcommittee. Most rotator cuff injuries are due to muscle imbalances of the shoulder.
The shoulder joint of the wheelchair user is the primary joint for transfer and propulsion. Pdf development of the wheelchair users shoulder pain. The study indicates that women in general are at high risk for work related neck pain. Abstract upwards of 70% of manual wheelchair users mwus experience shoulder pain. Today, do you or would you have any difficulty at all with. Effectiveness of exercise programs for management of. Wheelchair users shoulder pain index finding the right brand that supports wheelchair users with a multitude of support is often times difficult. Objectives to investigate the presence of ultrasound us abnormalities in manual wheelchair users with spinal cord injury sci using a quantitative ultrasound shoulder pathology rating scale usprs.
Prevalence of selfreported shoulder pain, level of shoulder. Translation and crosscultural adaptation of the danish. Pdf reliability and validity of the wheelchair users. The rotator cuff is the common site of trauma among nonathletic wheelchair users. Incidence of pain prolonged wheelchair use is associated with secondary musculoskeletal and neurologic upper extremity injuries. The mri scans demonstrated tendon tears in 70% of examined shoulders, and 90% of the rotator cuff tears occurred at the tendon insertion site. The international classification of functioning, disability and health icf is a framework for describing functioning and disability in relation to a health condition. Social security disability benefits for shoulder pain. Shoulder pain and pathology are common in manual wheelchair mwc users with paraplegia, and the biomechanical mechanism of injury is largely unknown.
Methods 37 clinician participants independently watched the videos of 11 patient participants undergoing the ssmp and recorded each patients response as improved partially or completely, no change or worse. Disabilities of the arm, shoulder, and hand questionnaire dash and its short version quickdash, shoulder pain and disability index spadi, american shoulder and elbow surgeons ases society standardized shoulder assessment form, constant murley score cs, simple shoulder test sst, oxford shoulder score oss, shoulder disability questionnaire. Effect of twospeed manual wheelchair wheel on shoulder pain in wheelchair users 1,2 finley ma, 1rodgers mm 1university of maryland school of medicine, department of physical therapy and rehabilitation science, baltimore, md. To investigate the presence of ultrasound us abnormalities in manual wheelchair users with spinal cord injury sci using a quantitative ultrasound shoulder pathol. The wheelchair users shoulder pain index wuspi was designed to measure shoulder pain in individuals who use wheelchairs. The wuspi targets activity limitation resulting from shoulder pain 4 subsections, including wheelchair transfers, wheelchair mobility, selfcare and general activities.
Participants also completed the wheelchair users shoulder pain index wuspi. Effectiveness of home exercise on pain, function, and strength of manual wheelchair users with spinal cord injury. Zhao 5 division of orthopedic research, department of orthopedic surgery, mayo clinic, rochester, mn, usa. Development of the wheelchair users shoulder pain index wuspi.
Active neck muscle training in the treatment of chronic. Shoulder surgery in paraplegics shoulderdoc by prof. Acupuncture and trager psychophysical integration in the treatment of wheelchair user s shoulder pain in individuals with spinal cord injury trevor a. Research article detailed shoulder mri findings in manual. Shoulder pain is a common problem in wheelchair users with a thoracic spinal cord. Correlation between shoulder pain and spinal mobility in. Prevalence of shoulder pain in adult versus childhoodonset. There is a lot of conflicting information about n95 respirators and surgical mask and how effective they are at preventing the user from contracting a virus infection like influenza, aka the flu. Each condition has specific requirements or criteria that have to be met in order for an individual to be approved for social security disability benefits.
Upper extremity functional index uefi page 2 we are interested in knowing whether you are having any difficulty at all with the activities listed below because of your upper limb problem for which you are currently seeking attention. The glenohumeral joint shoulder is the most mobile joint in the body. Shoulder pain and disability index please place a mark on the line that best represents your experience during the last week attributable to your shoulder problem. The wheelchair users shoulder pain index wuspi is a selfreport questionnaire designed to assess shoulder pain in wheelchair users during daily functional activities. Overall it was found that shoulder pain was associated with smaller variability of peak shoulder resultant force across a range of propulsion speeds. However, the wheelchair user s shoulder pain index wuspi changes were not. Wheelchair users shoulder pain index wuspi spinal cord. Wheelchair users shoulder pain index wuspi spinal cord injury. Many women with neck pain develop chronic neck pain which is pain lasting more than a month. Reliability and validity of the wheelchair users shoulder pain index wuspi. Shoulder pain and disability index fax 800 5998350 patient last name patient first name patient id date of birth mmddyyyy. Webbased information may be especially helpful for people who live far away from a clinic. Research article detailed shoulder mri findings in manual wheelchair users with shoulder pain melissam.
While there is no set listing for shoulder pain, there are listings for underlying medical conditions that cause shoulder pain and shoulder problems. Shoulder pain among rehabilitated spinal cord injured persons. Clinical trial of exercise for shoulder pain in chronic. Increased body mass index deconditioning psychological stress. Detailed shoulder mri findings in manual wheelchair users.
David lanza mspt a 3 morey kolber mspt a 2 richard s. Prevalence and identification of shoulder pathology in. The current study examined whether the prevalence of shoulder pain in adult wheelchair users who began using their wheelchairs during childhood childhoodonset cho group is similar to those who began using their wheelchairs as adults adultonset ado group. User s shoulder pain index pcwuspi methods equipment. The objective of this study was to use threedimensional freehand ultrasound to measure scapular kinematics and to determine how scapular motion relates to subject characteristics, clinical exam scores, shoulder pain, and years of wheelchair use among manual wheelchair users mwus. The prevalence rate of shoulder pain among paraplegics who use manual wheelchairs was 62%.
The file size of this svg image may be abnormally large because most or all of its text has been converted to paths rather than using the more conventional element. Shoulder pain is associated with lower qualityoflife ratings and physical activity in patients with sci. Shoulder pain is very common in people who are wheelchair dependent, including those with spinal cord injury, spina bifida and. Decreased range of motion rom has been suggested as a major contributor, but the interaction of sex, rom, and shoulder pain has not been investigated, thus the purpose of this investigation. Manual therapy and neuromuscular reeducation were provided in an outpatient setting, along with a custom exercise tracker and motivational interviewing to enhance adherence. Repetitive strain injury among manual wheelchair users. Finley and rodgers 15 identified manual wheelchair users that experienced pain, these users then underwent a clinical evaluation for diagnosis. Effectiveness of home exercise on pain, function, and.
More than half of all people with weightbearing shoulders wheelchair users and crutch users develop shoulder pain gellman, 1988. Shoulder pain in wheelchair users with tetraplegia and. Shoulder ultrasound abnormalities, physical examination findings, and pain in manual wheelchair users with spinal cord injury. Relationship between perceived shoulder pain and kinematic.
Prevalence of shoulder pain in adult versus childhood. This material is the result of work supported with resources from the. Many long term wheelchair users develop shoulder pain. Development of the wheelchair users shoulder pain index. Managing upper extremity pain with the right wheelchair. Development of the wheelchair user s shoulder pain index wuspi. Two authors took the diagnostic approach 15,41, they cited pain as a type of shoulder complaint but did not exclusively search for shoulder pain, instead they studied shoulder pathology. Wheelchair users shoulder pain index how is wheelchair users shoulder pain index abbreviated. Shoulder pain in wheelchair users with tetraplegia and paraplegia1999 apr.
Karman provides wheelchair users with resources that starts with a wide range of product information, national dealers support, and a multitude of information easily found on this website. Finally the shoulder may become uncomfortable even with the. The wheelchair user s shoulder pain index wuspi is a simple and effective selfreport questionnaire for quickly measuring the functional cost of shoulder pain in wheelchair users. Each header notes the inventory, the dimension or index and the corresponding score form page. A pilot index was created to measure shoulder pain and related difficulty during basic and instrumental activities of daily living. Original article shoulder ultrasound abnormalities, physical. Shoulder ultrasound abnormalities, physical examination findings, and pain in manual wheelchair users with spinal. Statistically significant differences were found between wheelchair basketball players with trunk control and wheelchair basketball players with trunk control with respect to the duration of their disability, the daily number of transfers made to wheelchair, and performance corrected wheelchair user s shoulder pain index pcwuspi score p users shoulder pain index wuspi is a simple and effective selfreport questionnaire for quickly measuring the functional cost of shoulder pain in wheelchair users. The symptoms of your shoulder problems will depend on the specific type of problem you are having. It is composed of 15 items relating to pain in everyday activities of wheelchair users including. A 52 yearold male with cooccurring disorder was referred for neck and shoulder pain. Pain around the shoulder, often at the outer portion of the upper arm pain that is worse with shoulder function, especially when reaching overhead or lifting occasionally, aching when not using the arm often, pain that awakens you at night occasionally, tenderness, swelling, warmth, or redness over the other aspect of the.
The wheelchair users shoulder pain index shows high levels of reliability and internal consistency, as well as concurrent validity with loss of shoulder range of motion. Most shoulder problems happen when the soft tissues in the shoulder break down. Clinicians often need to quantify patients shoulder pain and gauge the implications of their shoulder pain on their independence and abilities to perform activities of daily. Effect of twospeed manual wheelchair wheel on shoulder pain. A study of shoulder motion and impingement in manual.
Clinicians often need to quantify patients shoulder pain and gauge the implications of their shoulder pain on their independence and abilities to perform activities of daily living. Shoulder pain in wheelchair users with tetraplegia and paraplegia. The wheelchair users shoulder pain index wuspi is a simple and effective selfreport. Items assess intensity of shoulder pain during transfers, activities of daily living, and mobility performed from a wheelchair. The causes of this sex discrepancy are not understood. Threedimensional freehand ultrasound to measure scapular. The wuspi contains 15 items, scaled 010 on a visual analog scale 10 worst pain ever experienced. Wheelchair users shoulder pain index listed as wuspi. Following a 6month home exercise program, subjects in the shoulder pain group reported improvements in shoulder pain during the performance of activities of daily living. The wuspi was designed to measure the severity of shoulder pain related to functional activity of manual wheelchair users in daily living curtis et al. Jan 10, 2016 there is evidence that reduced mobility of upper thoracic segments is related to neck andor shoulder pain.
Shoulder pain is a problem in up to 86% of persons with spinal cord injury. Wheelchair user s shoulder pain index rehabmeasures database skip to main content. The surprising truth about n95 respirators vs surgical. Whether the prevalence and pathology of shoulder pain is. Van straaten mg1, cloud ba2, morrow mm1, ludewig pm3, zhao kd4. Even a minor injury to the shoulder can impair a persons ability to achieve independence. Currently, no incidence of shoulder pain in individuals with sci either congenital or traumatic who have used wheelchairs since early childhood has been reported. Reliability and validity of the wheelchair users shoulder pain index. Establishing patterns of mri characteristics in mwc users would help advance understanding of the mechanical etiology of rotator cuff disease, thus improving the logic for prescribed interventions. Shoulder ultrasound abnormalities, physical examination.
Wheelchair use encourages thoracic kyphosis with shortened anterior muscles and lengthened posterior muscles, placing the user at increased risk for upper extremity dysfunction and pain. This mobility predisposes it to injury from overuse, especially in the absence of protective mechanisms of pain and proprioception. The wuspi targets activity limitation resulting from shoulder pain 4,including wheelchair transfers, wheelchair mobility, selfcare and general activities. Common shoulder pathologies associated with wheelchair use are impingement syndrome, capsulitis, osteoarthritis, recurrent dislocations, rotator cuff tear, bicipital tendinitis, and myofascial pain syndrome. The shoulder is the most common site of pain reported by the wheelchair population. The instrument was administered to 64 wheelchair users at an athletic event. The wheelchair users shoulder pain index wuspi is a simple and effective selfreport questionnaire for quickly measuring the functional cost of shoulder pain in wheelchair users. Abstract shoulder pain is a common overuse problem in longterm adult wheelchair users. Pdf chronic shoulder pain is a frequently reported phenomenon in individuals who use wheelchairs as their primary means of mobility. Circle the number that best describes your pain where. Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Impingement syndrome rotator cuff tendinitis, bursitis. In advanced cases, however, and after repeated attacks, the shoulder may be felt to slip out and clunk back into place with increasing ease and in an increasing number of activities.
We compared 31 cho and 22 ado wheelchair users using the wheelchair users shoulder pain index wuspi, an overall pain score brief pain inventory. Wheelchair user s shoulder pain index wuspi description. At the 12month followup visit, patients were asked to describe how the training. Wheelchair users shoulder pain index how is wheelchair. The purpose of this study is to quantify shoulder movement during manual wheelchair based activities of daily living and to determine the associated likelihood of shoulder soft tissue compression. The wheelchair user s shoulder pain index wuspi summary shoulder pain is very common in people who are wheelchair dependent, including those with spinal cord injury, spina bi. Archives of physical medicine and rehabilitation 8911. Relationship between perceived shoulder pain and kinematic analysis of wheelchair propulsion in sedentary and active wheelchair users isabel rossignoli hector alegre azael herrero juan martinhernandez pedro j. Headers are provided throughout the chapter to assist the tester in locating the dimensions and indices in the manual during test administration. Effectiveness of exercise programs for management of shoulder. Please place a mark on the line that best represents your experience during the last week attributable to your shoulder. Original article shoulder ultrasound abnormalities.
It provides a common language and framework for describing the level of function of a person within their unique environment. Frequent overuse injuries include muscle strain, rotator cuff tears, and impingement. Unless rendering the text of the svg file produces an image with text that is incurably unreadable due to technical limitations, it is highly recommended to change the paths back to text. The purpose of this investigation was to examine the relationship between shoulder pain in manual wheelchair users and variability of peak resultant force on the shoulder during wheelchair propulsion. Acupuncture and trager psychophysical integration in the. Effect of twospeed manual wheelchair wheel on shoulder. Pushing a wheelchair for 10 minutes or more, and propulsion up ramps or inclines outdoors were the most common activities that caused and exacerbated shoulder pain. Shoulder pain among rehabilitated spinal cord injured persons using manually propelled wheelchairs in the gaza strip. To ensure equivalence between content in the original and the swedish version of the wuspi, we. We are committed to sharing findings related to covid19 as quickly and safely as possible. Journal of rehabilitation medicine shoulder pain in persons with.
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