Transfer technique is associated with shoulder pain and pathology in people with spinal cord injury: A cross-sectional investigation

Publication date: Available online 23 April 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Nathan S. Hogaboom, Lynn A. Worobey, Michael L. Boninger
ObjectivesTo evaluate how transfer technique and subject characteristics relate to ultrasound measures of shoulder soft tissue pathology, and self-reported shoulder pain during transfers in a sample of wheelchair users with spinal cord injury (SCI).DesignCross-sectional observational study.SettingResearch laboratory, national and local veterans' wheelchair sporting events.ParticipantsA convenience sample of 76 wheelchair users with non-progressive SCI. Participants were over 18 years old, greater than one year post-injury, and could complete repeated independent wheelchair transfers without the use of their leg muscles.InterventionsN/AMain OutcomesTransfer pain items from the Wheelchair User's Shoulder Pain Index; Transfer technique assessed using the Transfer Assessment Instrument (TAI); shoulder pathology markers examined using the Ultrasound Shoulder Pathology Rating Scale (USPRS).ResultsBetter transfer technique (higher TAI) correlated with less injury (lower USPRS) (partial-η²=.062, p<.05) and less pain during transfers (partial-η²=.049, p<.10). Greater age was the strongest predictor of greater pathology (USPRS total: partial-η²=.225, supraspinatus grade: partial-η²=.174, p<.01). An interaction between technique and weight was found (p<.10): participants with lower bodyweights showed a decrease in pathology markers with better transfer technique (low-weight: R²=0.422, p<.05; middle-weight: R²=0.200, p<.01), while those with higher weight showed little change with technique (R²=0.018, p>.05).ConclusionsParticipants with better transfer technique exhibited less shoulder pathology and reported less pain during transfers. The relationship between technique and pathology was strongest in lower-weight participants. While causation cannot be proven due to study design, it is possible that using a better transfer technique and optimizing bodyweight could reduce the incidence of shoulder pathology and pain.



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