Article

OBJECTIVES: To determine (1) agreement of musculoskeletal ultrasound (MSK-US)
findings of shoulder pathology and related shoulder special test results in
individuals with varied durations of manual wheelchair (MWC) use after spinal
cord injury (SCI); and (2) whether shoulder musculoskeletal impairments, per
MSK-US and clinical examination, differed in individuals with SCI and varying
durations of MWC use. DESIGN: Cross-sectional cohort study. SETTING: Laboratory
setting. PARTICIPANTS: Adult volunteers (N=23) with SCI who used an MWC for
community mobility. Individuals were stratified into 3 groups based on duration
of MWC use: <5 years, 5 to 15 years, and >15 years. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Special tests for shoulder impingement and
bicipital tendonitis were performed. Bilateral shoulder MSK-US was performed,
with the Ultrasound Shoulder Pathology Rating Scale (USPRS) quantifying biceps
tendon, supraspinatus tendon, and greater tuberosity cortical surface
impairments. RESULTS: No agreement was found between MSK-US and related special
tests. Special tests failed to identify impairment in 33.3% to 100% of those
identified on MSK-US. The total USPRS score was highest in those with >15 years'
MWC use. A higher proportion of dynamic impingement (supraspinatus and biceps)
was found in those with >15 years' MWC use, with other MSK-US items having
moderate effect sizes among duration-use groups. CONCLUSIONS: MSK-US identified
shoulder impairments more frequently than commonly used special tests. A
significant increase in the presence of MSK-US shoulder impairments was
identified in the longest-duration group. This was not the case for special tests
or pain. MSK-US is an easily administered, low-cost, noninvasive method for
determining shoulder impairments and should be used in routine screening of
individuals who use an MWC after SCI.
CI - Copyright (c) 2018 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS