The influence of shoulder pain on functional limitation, perceived health, and depressive mood in patients with traumatic paraplegia

Abstract

Objective: To assess whether functional activity, perceived health, and depressive symptoms differ between individuals with traumatic paraplegia with and without shoulder pain. Design: Cross sectional and comparative investigation using the unified questionnaire. Setting: Neural Regeneration and Repair Division unit of Taipei Veterans General Hospital in Taiwan. Participants: Seventy-six patients with paraplegia (23 with and 53 without shoulder pain) who had experienced spinal cord injury at American Spinal Injury Association Impairment Scale T2 to T12 neurologic level (at least 6 months previously). Outcome measures: Spinal Cord Independence Measure (SCIM), a single item from the Medical Outcomes Study 36-Item Short-Form Health Survey, and Patient Health Questionnaire-9 (PHQ-9) depression scale. Results: Shoulder pain was prevalent in 30% patients. Patients with shoulder pain had significantly worse perceived health and greater depressive symptoms than those without. No significant difference was found in functional ability between groups. Greater shoulder pain intensity was related to higher depressive scores (r = 0.278, P = 0.017) and lower self-perceived health scores (r = −0.433, P < 0.001) but not SCIM scores (P = 0.342). Conclusion: Although shoulder pain was unrelated to functional limitation, it was associated with lower perceived health and higher depressive mood levels.

Psychosocial aspects of spinal cord injury pain: a meta-analysis

“…Only a few studies provided separate demographic information for participants with and without SCI pain. 26,29,38 Participants reported experiencing neuropathic (at-level and below-level) pain and/or nociceptive (musculoskeletal, visceral) pain. The two acute SCI studies reported ongoing pain from injury onset.…”

“…This resulted in a final sample of 16 independent studies. 11,18,24,26,[29][30][31][32][33][34][35][36][37][38][39][40] Data extraction and organisation…”

Prevalence of Shoulder Pain in Spinal Cord Injury Patients Referring to the Brain and Spinal Cord Injury Research Center of Tehran University of Medical Sciences

“…Age, gender, injury level, injury duration and the number of times moving from wheelchair onto bed and back factors which reported in previous research affect shoulder pain (23)(24)(25). Studies also indicated that the time passed after the injury and transferring from wheelchair to bed and back were considered as influential factors on shoulder pain (11,26). In a systematic review carried out in 2014, shoulder pain prevalence among quadriplegic patients has been reported to be more frequent in general.…”

Reverse Shoulder Arthroplasty in Weight‐Bearing Shoulders of Wheelchair‐Dependent Patients: Outcomes and Complications at 2 to 5 years

“…Thus, it is not surprising that shoulder pain and dysfunction is very common in these patients [20]. Although loss of shoulder function has a significant negative impact on the independence and quality of life of these patients [9], there are few studies investigating the treatment of shoulder disorders in this population. Surgical treatment of shoulder disorders in wheelchair‐dependent individuals is a challenging scenario for both patients and surgeons.…”

“…Not surprisingly, the prevalence of shoulder disorders in wheelchair-dependent patients is greater than in the general population [1][2][3][4][5][6]. Shoulder pathology has a substantial negative impact on patients' autonomy, quality of life, and physical, and psychological and social well-being [7][8][9]. Hence, investigations on the treatment of shoulder pain and dysfunction in wheelchairdependent patients are very relevant.…”