Sex, shoulder pain, and range of motion in manual wheelchair users

Abstract

Abstract-Upwards of 70% of manual wheelchair users (MWUs) experience shoulder pain. Pain is more prevalent among females than males. The causes of this sex discrepancy are not understood. 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. We divided 30 MWUs (18 males, 12 females; 21.93 +/-3.77 yr) into two groups based on self-reported shoulder pain: pain group (n = 14; 9 males, 5 females) and no pain group (n = 16; 9 males, 7 females). We used a digital goniometer to assess ROM. Participants' shoulder active and passive ROMs were tested bilaterally on the following joint motions: flexion, extension, abduction, adduction, internal rotation, and external rotation. We used a visual analog scale to assess shoulder pain. Of the participants, 47% reported shoulder pain. Overall, the no pain group had greater ROM than the pain group, with further analysis revealing this association was only significant in females during extension (p < 0.05). ROM impairments were only present in extension in females with shoulder pain. The mechanism underlying this sex difference is not clear.

Expert’s opinion of a home-based exercise program for shoulder pain prevention: application in wheelchair basketball players.

“…Most of the previous studies report shoulder injuries as a main problem in this population (Samuelsson, Tropp, & Gerdle, 2004;Wessels, Brown, Ebersole, & Sosnoff, 2013), being SP one of the most common symptoms of physical dysfunction, mainly as a consequence of the increased load at this joint and repetitive stress of daily and sport activities (Fullerton et al, 2003;Nyland, Robinson, Caborn, Knapp, & Brosky, 1997). About 70% of wheelchair user's population has experienced SP in some moment of their life (Curtis, Roach, Applegate, Amar, Benbow, Genecco, et al, 1995).…”

Effects of a therapeutic exercise program for injuries prevention in wheelchair basketball (WB) players = Efectividad de un programa de ejercicios terapéutico para la prevención de lesiones de jugadores de baloncesto en silla de ruedas (BSR)

“…According to previous studies (García -Gómez & Pérez-Tejero, 2016;Wessels et al, 2013), the correlation between SP and joint mobility could affect WB skills performance. These can be affected by the health condition, shoulder injury, functional class and wheelchair propulsion, among others.…”

“…The architecture of the shoulder, because of its limited stability and small supporting musculature is not well designed for the tasks required of manual wheelchair users (Van Straaten, Cloud, Morrow, Ludewig, & Zhao, 2014). For that reason, wheelchair users may report SP as a common problem in this population, showing a Introduction range from 14% up to 85% of SP in different studies (Curtis & Black, 1999;Ballinger, Rintala & Hart, 2000;Fullerton, Borckardt, & Alfano, 2003;Pérez-Tejero, Martínez-Sinovas, & Rossignoli, 2006;Samuelsson, Tropp, & Gerdle, 2004;Wessels, Brown, Ebersole, & Sosnoff, 2013). Previous studies have reported shoulder injuries as a common problem in WB (Nyland, Robinson, Caborn, Knapp, & Brosky, 1997;Curtis & Black, 1999;Pérez-Tejero et al, 2006), and these are mainly from the increased load at this joint and repetitive stress of ADLs and sport activities (Fullerton et al, 2003).…”

“…In this regard, ROM could be influenced by propulsion technique, therefore it can be inferred that it is necessary to develop shoulder strategies to initiation ROM with adequate muscle balanced (control) and power (Starrs, Chohan, Fewtrell, Richards, & Selfe, 2012). Wheelchair users with no SP had greater ROM than those who had SP (Wessels, Brown, Ebersole, & Sosnoff, 2013).…”

“…Some studies focused on the shoulder as the common place of pain reported by the wheelchair user population Finley & Rodgers, 2004;Samuelsson et al, 2004;Yildirim et al, 2010). Many factors such as age, gender, wheelchair use and time since injury are correlated with shoulder pain (Wessels et al, 2013;Kentar et al, 2018;Finley, Ebaugh, & Trojian, 2018). Although shoulder pain (SP) initially can limit the capacity of the individual to perform activities independently, it may involve functional costs for the wheelchair user (Mulroy et al, 1996).…”