While shoulder pain is quite common in manual wheelchair users and propulsion biomechanics are believed to play a significant role in the development of upper extremity pain laplante and kaye, 2010, no previous research has documented an association between forces acting on the shoulder and symptomatic shoulder pain collinger et al. Shoulder management for wheelchair users from acute care to home program. 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. After 33 years of pushing a wheel chair 15 with power assist wheels and finally getting a power chair and an ez lock system to drive from the chair, my shoulders still hurt. Effect of a standard exercise protocol on shoulder pain in longterm wheelchair users. Pdf development of the wheelchair users shoulder pain index.
The wheelchair users shoulder pain index wuspi, wheelchair users functional assessment wufa, and timed hill climb test with rating of perceived exertion rpe. This study documents a strong influence of shoulder pain on the performance of. Shoulder pain is a common problem in wheelchair users with a. Wheelchair user s shoulder pain index rehabmeasures database skip to main content. How to reduce or eliminate shoulder and wrist pain when pushing a wheelchair. Chronic pain incidence was investigated in 384 sci carriers. T1 detailed shoulder mri findings in manual wheelchair users with shoulder pain. The glenohumeral joint shoulder is the most mobile joint in the body. Pdf reliability and validity of the wheelchair users. How to alleviate shoulder pain from pushing a wheelchair. Circle the number that best describes your experience where.
The wuspi targets activity limitation resulting from shoulder pain 4,including wheelchair transfers, wheelchair mobility, selfcare and general activities. Reliability of infrared thermography in skin temperature. Shoulder pain among rehabilitated spinal cord injured persons. Each item is selfrated on a 10 cm visual analog scale vas anchored with no pain and worst pain ever experienced. Relationship between perceived shoulder pain and kinematic. Common shoulder pathologies associated with wheelchair use are impingement syndrome, capsulitis, osteoarthritis, recurrent dislocations, rotator cuff tear, bicipital tendinitis, and myofascial pain syndrome. An array of factors could contribute to shoulder pain. Wheelchair users shoulder pain index elderly mobility. This booklet will discuss interventions to facilitate a healthy shoulder from the time of injury to post rehabilitation home programs. It measures how shoulder pain has interfered with different daily activities, such as transferring, wheeling, and selfcare. Shoulder ultrasound abnormalities, physical examination findings, and pain in manual wheelchair users with spinal cord injury. To investigate the presence of ultrasound us abnormalities in manual wheelchair users with spinal cord injury sci using a quantitative ultrasound shoulder pathol. Wheelchair users shoulder pain index wuspi spinal cord injury. Shoulder pain among rehabilitated spinal cord injured.
Many long term wheelchair users develop shoulder pain. Upper body resistance exercises are an excellent way to build strength and. Several studies have shown that shoulder pain is prevalent in 33% to 78% of athletes who are wheelchair users. The wuspi targets activity limitation resulting from shoulder pain 4 subsections, including wheelchair transfers, wheelchair mobility, selfcare and general activities. Sex, shoulder pain, and range of motion in manual wheelchair. Check out the september 25, 2019 sci forum revolutionay shoulder care for sci. Due to the increased work demand of the shoulders and arms, wheelchair users often have shoulder pain and dysfunction.
Utilizing the upper extremities as primary movers for transfers and mobility is a challenge beyond the limits of a shoulders anatomical design. Across the 7 studies, the exercise intervention was associated with reduction in shoulder pain that exceeded the estimated minimal detectable change of 5. Shoulder pain is a common overuse problem in longterm adult wheelchair users. A 3part questionnaire on patient characteristics, medical history, supplemental questions, and the. If a person does not answer all questions divide by the total possible score, eg. The purpose of this study is to quantify shoulder movement during manual wheelchairbased activities of daily living and to determine the associated likelihood of shoulder soft tissue compression.
Protecting your shoulders and staying active after spinal. Prevalence of shoulder pain in adult versus childhoodonset. Shoulder pain and its consequences in paraplegic spinal cord. The wuspi targets activity limitation resulting from shoulder pain 4 subsections, including wheelchair transfers, wheelchair mobility, selfcare and general. Research article detailed shoulder mri findings in manual. All subjects who met the inclusion criteria completed the wuspi and the srq and provided patient satisfaction scores. Shoulder strength and physical activity predictors of shoulder pain. The ratings on each of the 15 items are added together for a total score ranging from 0150. Zhao 5 division of orthopedic research, department of orthopedic surgery, mayo clinic, rochester, mn, usa. Shoulder pain in persons with thoracic spinal cord injury. Toronto rehabilitation institute hand function test 59.
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. Of those with current shoulder pain, 37% had not sought medical attention. Shoulder ultrasound abnormalities, physical examination. Wheelchair users shoulder pain index rehabmeasures database. Pdf development of the wheelchair users shoulder pain. Wheelchair users shoulder pain index wuspi spinal cord. Two recent projects of the manual wheelchair research program at mayo clinic have included. Introduction high prevalence of shoulder injuries in manual wheelchair users mwu curtis, 1999. Wheelchair users shoulder pain index listed as wuspi.
Each item is scored from 0 to 10, with 10 representing shoulder pain that has completely interfered with activity during the. The documentation of an initial increase in pain scores is an. Tool for assessing mobility in wheelchairdependent paraplegics harvey mobility assessment tool 58. Twentythree patients 50% complained of oppositeside shoulder pain during wheelchair propulsion. Woman with chronic pain explains that some wheelchair users. Acupuncture and trager psychophysical integration in the. One reported observation of shoulder pain and mwus is a sex bias. Ultrasonographic evaluation of the shoulder in elite. 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.
Shoulder pain in wheelchair users with tetraplegia and paraplegia. Association of shoulder pain with the use of mobility. Variability of peak shoulder force during wheelchair. This study investigated 1 the effect of repetitive weightrelief raises wr and shoulder external rotation er on the acromiohumeral distance ahd among manual wheelchair users mwus and 2 the relationship between shoulder pain, subject characteristics, and ahd changes. The wheelchair users shoulder pain index wuspi is a simple and effective selfreport. Indeed, upwards of 70 percent of mwus experience pain 27. A study of shoulder motion and impingement in manual.
Reliability and validity of the wheelchair user s shoulder pain index wuspi. One to two thirds of fulltime manual wheelchair users report upper extremity pain, many within the first year of injury pvacscm, 2005. The purpose of this study was to examine the reliability and validity of the wheelchair users shoulder pain index wuspi, an instrument. It measures how shoulder pain has interfered with different daily. Clinical trial of exercise for shoulder pain in chronic. Manual wheelchair users should also be aware of body. Overall it was found that shoulder pain was associated with smaller variability of peak shoulder resultant force across a range of propulsion speeds. 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. 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. 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. As wheelchair users are without the use of their legs, their reliance on their upper limbs is severely affected by potential shoulder pain.
Protecting your shoulders and staying active after spinal cord injury presented by kristin kaupang, physical therapist, on april 10, 2012 at the university of washington medical center, seattle, wa. The wheelchair users shoulder pain index wuspi was designed to measure shoulder pain in individuals who use wheelchairs. Shoulder pain and pathology are common in manual wheelchair mwc users with paraplegia, and the biomechanical mechanism of injury is largely unknown. How to reduce or eliminate shoulder and wrist pain when. The wheelchair users shoulder pain index macquarie university. The srq is an outcome tool that is more typically used in. Some wheelchair users experience pain in upper limbs that interfere on essential daily activities, as when propelling the wheelchair itself, driving, dressing and performing transferences 10,11. Shoulder management for wheelchair users touchstone. The instrument was administered to 64 wheelchair users at an athletic event. 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. Shoulder pain intensity was assessed weekly by using the wheelchair users shoulder pain index wuspi, a 15item selfreport instrument. Apr 04, 2008 of those with current shoulder pain, 37% had not sought medical attention.
Sci, wheelchair information, and health and pa history s2 file. Wheelchair propulsion as well as transfers are supposed to cause and increase upper extremity pain, such as shoulder pain in active wheelchair users. Wheelchair sports association of newfoundland and labrador. The wuspi is a selfreport measure of shoulder pain in wheelchair users during functional activities. How common are shoulder problems with wheelchair mobility mobility 40%, push, fm, age j. Wheelchair user s shoulder pain index wuspi description. 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. Shoulder pain is a common problem in wheelchair users with a thoracic spinal cord injury, it seems more likely to occur with increased age, and is a potential cause of activity limitations. Managing upper extremity pain with the right wheelchair.
Detailed shoulder mri findings in manual wheelchair users. Spinal cord injury edge task force outcome measures. Effectiveness of exercise programs for management of shoulder. Original article shoulder ultrasound abnormalities. Im a power chair user, but i also rock a set of crutches, and for some reason thats difficult for some people to comprehend. Living with chronic pain means my condition varies every day im in pain, but some days are a lot worse than others. Blisters, abrasions, and lacerations are also frequent injuries although not necessarily overuse injuries. Strategies to thwart further disability from shoulder pain include primary prevention and rehabilitation. Walking index for spinal cord injury wisci, wisci ii 61. Abstract upwards of 70% of manual wheelchair users mwus experience shoulder pain.
Development of the wheelchair users shoulder pain index wuspi. Reliability and validity of the wheelchair users shoulder pain index wuspi article pdf available in paraplegia 3310. The shoulder joint of the wheelchair user is the primary joint for transfer and propulsion. Effect of twospeed manual wheelchair wheel on shoulder. To establish concurrent validity, the index was administered to 64 long term wheelchair users and index scores were compared to shoulder range. Effectiveness of exercise programs for management of. The wuspi is a reliable and validated 15item selfreport instrument that measures shoulder pain intensity in wheelchair users in the last seven days during various functional activities of daily living including transfers, wheelchair mobility, dressing, overhead lifting. Pdf chronic shoulder pain is a frequently reported phenomenon in individuals. The most commonly used assessment tools for shoulder pain in wheelchair users wcus are questionnaires mainly the wheelchair users shoulder. Development of the wheelchair users shoulder pain index wuspi article pdf available in paraplegia 335. The wheelchair users shoulder pain index wuspi was designed to measure. Exercise is a feasible, conservative, therapeutic intervention for the treatment of shoulder pain among mwus. Prevalence of shoulder pain in adult versus childhood. Acupuncture and trager psychophysical integration in the treatment of wheelchair users shoulder pain in individuals with spinal cord injury trevor a.
This mobility predisposes it to injury from overuse, especially in the absence of protective mechanisms of pain and proprioception. The wheelchair users shoulder pain index wuspi was designed to. The following information is provided by touchstone rehabilitation, author daniel m. Woman with chronic pain explains that some wheelchair. Original article shoulder ultrasound abnormalities, physical. Wheelchair users shoulder pain index how is wheelchair. Development of the wheelchair users shoulder pain index.
A visit to an orthopaedic physician and an xray will document. Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Research article detailed shoulder mri findings in manual wheelchair users with shoulder pain melissam. It is not surprising that manual wheelchair users mwus experience shoulder pain given the persistent use of their shoulders in activities of daily living. A pilot index was created to measure shoulder pain and related difficulty during basic and instrumental activities of daily living. Carpal tunnel syndrome is present in 23% to 73% of wheelchair users. Users shoulder pain index wuspi, a measure of pain during typical daily activities.
Effect of twospeed manual wheelchair wheel on shoulder pain. The wuspi is easy to administer and score, and takes a patient approximately 5 minutes to complete. 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. Journal of rehabilitation medicine shoulder pain in persons with. This places manual wheelchair users at a high risk of shoulder pain and injury 2. Wheelchair users shoulder pain index finding the right brand that supports wheelchair users with a multitude of support is often times difficult. Therefore, preventative measures should be developed to assist sci wheelchair users in avoiding shoulder issues that could impact their quality of life.
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. Of these, 3 described their pain as severe, 10 as moderate, and another 10 as mild. Nov 25, 2014 the most commonly used assessment tools for shoulder pain in wheelchair users wcus are questionnaires mainly the wheelchair users shoulder pain index wuspi and shoulder pain and disability. Shoulder pain and its consequences in paraplegic spinal. Tool for assessing mobility in wheelchair dependent paraplegics harvey mobility assessment tool 58. The wheelchair users shoulder pain index wuspi, a reliable and valid 15item questionnaire, was developed specifically for manual wheelchair users who are functionally independent curtis et al, 1995. When stratified by the use of assistive mobility devices, shoulder pain was reported by 46. The purpose of this study was to examine the reliability and validity of the wheelchair user s shoulder pain index wuspi, an instrument.
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. All subjects completed the wheelchair users shoulder pain index wuspi. Additionally, a medication log was provided for recording daily analgesic intake. To document the prevalence of shoulder pain, associated patient characteristics, and inte. Pdf reliability and validity of the wheelchair users shoulder pain. The causes of this sex discrepancy are not understood. Abstract shoulder pain is a common overuse problem in longterm adult wheelchair users. Items assess intensity of shoulder pain during transfers, activities of daily living, and mobility performed from a wheelchair. To document the prevalence of shoulder pain, associated patient characteristics, and intensity and interference with shoulder function in activities in wheelchair users. Users shoulder pain index wuspi initially and at bimonthly intervals during the 6month intervention. Effects of repetitive shoulder activity on the subacromial.
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