Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: a cross-sectional study (original) (raw)
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Musculoskeletal Pain Due to Wheelchair Use: A Systematic Review and Meta-Analysis
Pain and Therapy, 2021
Introduction: Wheelchair users are at a high risk of experiencing non-neuropathic pain of musculoskeletal origin as a result of being wheelchair-bound. The aim of this systematic review was to establish the prevalence of musculoskeletal pain in wheelchair users that is attributable to wheelchair use, and to describe the different pain syndromes and discuss risk factors and management options. Methods: After a systematic MEDLINE search, we identified 40 papers eligible for inclusion. Results: The pooled prevalence of musculoskeletal pain at any location was 50% (95% CI 33-67%). The most common pain syndrome was shoulder pain (pooled prevalence 44%, 95% CI 36-52%). Wheelchair users were 5.8 times as likely to suffer from shoulder pain as controls (95% CI 2.7-12.2, p \ 0.0001). Other pain syndromes included neck, elbow, wrist, hand and low back pain.Older age and increased duration of wheelchair use were the most significant determinants of pain in wheelchair users. Conclusions: Musculoskeletal pain as a result of wheelchair use is very common amongst wheelchair users. Management of pain should follow national and international guidelines. Optimal adjustment of seating position may prevent pain, and is important to be taken into consideration.
BMJ Open, 2021
IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medic...
The pain experiences of powered wheelchair users
Disability and Rehabilitation, 2012
Methods: EPIOC users receiving their chair between February and November 2002 (N=74) were invited to participate in a telephone questionnaire/interview and 64 (aged 10-81) agreed. Both specific and open-ended questions examined: presence of pain/discomfort, its severity, minimising and aggravating factors, particularly in relation to the EPIOC and its use. Results: Most EPIOC users described experiences of pain with 17% reporting severe pain. Over half felt their pain was influenced by the wheelchair and few (25%) considered their chair eased their symptoms. The commonest strategy for pain relief was taking medication. Other self help strategies included changing position, exercise and complementary therapies. Respondents emphasised the provision of backrests, armrests, footrests and cushions which might alleviate or exacerbate pain, highlighting the importance of appropriate assessment for this high dependency group. Conclusions: Users related pain to their underlying medical condition, their wheelchair, or a combination of the two. User feedback is essential to ensure the EPIOC meets health needs with minimum of pain. This becomes more important as the health condition of users changes over time.
South African journal of physiotherapy, 2022
To determine the presence of pain, the sociodemographic and injury profile of community-dwelling manual wheelchair users. Method: This quantitative correlational study used a sociodemographic and injury profile sheet and the Douleur Neuropathique 4 Questions (DN4) questionnaire to document demographic, SCI profiles as well as pain characteristics. Pain severity was determined using the Numeric Rating Scale. Data were analysed using the Statistical Package for the Social Sciences (SPSS) v27 at 0.05 level of significance. Results: The pain rate was 104; 85% of 122 participants and mainly in those with complete SCI (77.9%). Neuropathic pain was more common (76; 62.5%) and significantly associated (p < 0.05) with higher pain severity. Pain was mainly in one area of the body (59; 48.4%) but occurring in up to five areas. The most painful area had a mean severity of 6.7/10; was more common in the lower limbs below the injury level (48; 39.4%); and was burning in nature (40; 32.7%). Conclusions: Pain after SCI is as problematic in the South African context as it is globally. With the rising SCI prevalence in the country, understanding pain and its presentation is important for holistic management of a person with SCI. Clinical implications: In-depth assessment of pain should be conducted and appropriate management interventions for specific pain types be prescribed to effectively reduce pain.
National journal of integrated research in medicine, 2015
Background and Objectives: Numerous persons are dependent on a manual wheelchair for their mobility. They rely largely on the upper extremities for mobility and transfer, which eventually results in shoulder pain. Various studies had shown high prevalence of shoulder pain among wheelchair users. So, the purpose of this study was to see the relationship of shoulder pain intensity on quality of life and physical activity in persons who propel a manual wheelchair. Aim is to correlate the shoulder pain intensity with quality of life and physical activity in manual wheelchair users. Methodology: 35 subjects who met the criteria were included in the study. They were divided into two groups. Subjects of Group 1 (with shoulder pain) - completed a series of questionnaire (Wheelchair User’s Shoulder Pain Index , SF-36 Health Survey, Physical Activity Scale for Individuals With Physical Disabilities) administered by an interview process. And subjects of group 2 (without shoulder pain) complete...
Development of the Wheelchair User's Shoulder Pain Index (WUSPI)
Paraplegia, 1995
Chronic shoulder pain is a frequently reported phenomenon in individuals who use wheelchairs as their primary means of mobility. No indices are currently available which detect difficulties in performing daily activities due to shoulder discomfort in a largely independent population of wheelchair users. The Wheelchair User's Shoulder Pain Index (WUSPI) was designed to measure shoulder pain in individuals who use wheelchairs. A pilot index was created to measure shoulder pain and related difficulty during basic and instrumental activities of daily living. The instrument was administered to 64 wheelchair users at an athletic event. Analyses of internal consistency and interitem correlations were used to revise and refine the original instrument. Individual item analysis revealed that th.e subjects in this study experienced the most shoulder pain when wheeling up an inclir.c or on outdoor surfaces, when lifting an object from an overhead shelf, when trying to sleep, when transferring from tub to wheelchair and when washing their backs. The final 15-item index shows high internal consistency. This instrument is useful for both clinical and research purposes to detect and monitor shoulder pain and accompanying loss of function by wheelchair users.
Reliability and validity of the Wheelchair User's Shoulder Pain Index (WUSPI)
Paraplegia, 1995
Many long term wheelchair users develop shoulder pain. The purpose of this study was to examine the reliability and validity of the Wheelchair User's Shoulder Pain Index (WUSPI), an instrument which measures shoulder pain associated with the functional activities of wheelchair users. This 15-item functional index was developed to assess shoulder pain during transfers, self care, wheelchair mobility and general activities. To establish test-retest reliability, the index was administered twice in the same day to 16 long term wheelchair users and their scores for the two administrations were compared by intraclass correlation. To establish concurrent validity, the index was administered to 64 long term wheelchair users and index scores were compared to shoulder range of motion measurements. Results showed that intraclass correlation for test-retest reliability of the total index score was 0.99. There were statistically significant negative correlations of total index scores to range of motion measurements of shoulder abduction (r = -0.485), flexion (r = -0.479) and shoulder extension (r = -0.304), indicating that there is a significant relationship of total index score to loss of shoulder range of motion in this sample. The Wheelchair User's Shoulder Pain Index shows high levels of reliability and internal consistency, as well as concurrent validity with loss of shoulder range of motion. As a valid and reliable instrument, this tool may be useful to both clinicians and researchers in documenting baseline shoulder dysfunction and for periodic measurement in longitudinal studies of musculoskeletal complications in wheelchair users.
The Journal of Rehabilitation Research and Development, 2004
This study analyzed the effect of rear-wheel position on seating comfort and mobility efficiency. Twelve randomly selected paraplegic wheelchair users participated in the study. Wheelchairs were tested in two rear-wheel positions while the users operated the wheelchair on a treadmill and while they worked on a computer. Propulsion efficiency, seating comfort, and propulsion qualities were registered at different loads during the treadmill session. During the computer session, pelvic position, estimated seating comfort, and estimated activity performance were measured. The change in rear-wheel position affected wheelchair ergonomics with respect to weight distribution (p < 0.0001) and seat inclination angle (position I = 5° and position II = 12°). These changes had a significant effect on push frequency (p < 0.05) and stroke angle (p < 0.05) during wheelchair propulsion. We found no consistent effect on mechanical efficiency, estimated exertion, breathlessness, seating comfort, estimated propulsion qualities, pelvic position, or activity performance.
Prevalence of shoulder pain and disability in adult using manual wheelchair, a cross sectional study
Pakistan BioMedical Journal
The objective of this study is to find out prevalence of shoulder pain and disability in adults using manual wheelchair in Pakistan. Study Design: Cross sectional study.Setting: Data was collected from Ghurki Trust Teaching Hospital, Pakistan Society for the Rehabilitation of the Disabled and Mayo hospital of Lahore. Methods: This is a cross-sectional study. After taking consent and IRB from UOL, this study was conducted on manual wheel chair use from at least three months of Lahore. It included both males and females of 25 above age. (SPADI) Shoulder pain disability index (SPADI) and the Wheelchair User's Shoulder Pain Index (WUSPI) will be used to collect data. The questionnaire was filled at the spot. Results: Out of total 127 participants 48.8% were female and 51.2% were male. The mean age of the study subjects was 32.32±4.719 years. The prevalence of shoulder pain was documented in 127 participants is 78% with moderate pain 27.6% and severe pain in 38.0%. There was mild dis...
Prevalence of shoulder pain in adult- versus childhood-onset wheelchair users: A pilot study
The Journal of Rehabilitation Research and Development, 2004
Shoulder pain is a common overuse problem in long-term adult wheelchair users. The current study examined whether the prevalence of shoulder pain in adult wheelchair users who began using their wheelchairs during childhood (childhood-onset [CH-O] group) is similar to those who began using their wheelchairs as adults (adult-onset [AD-O] group). We compared 31 CH-O and 22 AD-O wheelchair users using the Wheelchair User's Shoulder Pain Index (WUSPI), an overall pain score (Brief Pain Inventory), and a lifestyle questionnaire to determine frequency and duration of physical activity. Shoulder pain (WUSPI) was greater in the AD-O wheelchair users compared with the CH-O group (p < 0.008), even though their general lifestyles were not different. The immature skeleton can possibly respond to the repetitive forces of wheeling better than that of those who begin using a wheelchair once their skeletal structure is completely developed.