Shoulder Kinematics and Acute Ultrasonographic Changes in Manual Wheelchair Users With Spinal Cord Injury

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Status: Completed

Conditions: Traumatic Spinal Cord Injury

Treatments: Other: Wheelchair propelling test; Diagnostic Test: Musculoskeletal ultrasonography

Study type: Observational

Funder types: Other

Identifiers

NCT04712188

10

Details and patient eligibility

About

People who lose function of the lower limb due to spinal cord injury (SCI) need to use their arms for activities of daily life especially during weight-bearing tasks, such as transfers, and manual wheelchair (MWC) propulsion in order to maintain mobility. Persistent use of the upper limbs constitutes biomechanical difficulties, especially in the shoulder joint. The most commonly affected area in the shoulder is supraspinatus and biceps tendon. Four different stoke patterns have been classified in MWC users. Distinct amounts of force may be applied to the shoulder joint during propulsion with different stroke patterns and this can affect the shoulder tendons in different rates. In this study, investigators aimed to evaluate and compare the acute sonographic changes in supraspinatus and biceps tendons after a wheelchair propelling test in MWC users with SCI with different stroke patterns. Also, it is intended to determine the risk factors related to the stroke patterns that may be associated with these sonographic changes.

Full description

Fourty male MWC users with SCI were will be divided into 4 groups according to their stroke patterns (arcing, semicirculer, single loop, and double loop). Participants will use their own wheelchairs with their preferred stroke pattern for 20 minutes at a speed of 1 m / s on a motorized treadmill for a wheelchair propelling test. Wheelchair propelling videos will be recorded during the test. Shoulder kinematics will be analyzed using Kinovea motion analysis software and stoke pattern will be confirmed. Ultrasonographic assesment of participants' nondominant shoulder will be performed before and after testing procedure.

Enrollment: 40 patients

Sex: Male

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• People with traumatic spinal cord injury
• Age between 18 to 65 years,
• Neurologic injury level at T2 or below, with AIS grade A or B,
• Time since injury at least 6 months,
• Using manual wheelchair as their primary mobility tools

Exclusion criteria

• Fractures in nondominant upper limb at any time,
• Shoulder surgery within the past 5 years or corticosteroid injections within the past 3 months to the nondominant shoulder,
• Upper limb pain that restricts propulsion of a manual wheelchair,
• A history of cardiopulmonary problems and degenerative joint diseases

Trial design

40 participants in 4 patient groups

Arcing

Description:

10 patients with traumatic spinal cord injury using the "arcing" stroke pattern to propel manual wheelchair

Treatment:

Diagnostic Test: Musculoskeletal ultrasonography

Other: Wheelchair propelling test

Semicirculer

Description:

10 patients with traumatic spinal cord injury using the "semicirculer" stroke pattern to propel manual wheelchair

Treatment:

Diagnostic Test: Musculoskeletal ultrasonography

Other: Wheelchair propelling test

Single loop

Description:

10 patients with traumatic spinal cord injury using the "single loop" stroke pattern to propel manual wheelchair

Treatment:

Diagnostic Test: Musculoskeletal ultrasonography

Other: Wheelchair propelling test

Double loop

Description:

10 patients with traumatic spinal cord injury using the "double loop" stroke pattern to propel manual wheelchair

Treatment:

Diagnostic Test: Musculoskeletal ultrasonography

Other: Wheelchair propelling test