Agreement of Musculoskeletal Ultrasound and Clinical Assessment of Shoulder Impairment in Manual Wheelchair Users with Various Duration of Spinal Cord Injury

Publication date: Available online 12 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Margaret Finley, David Ebaugh, Thomas Trojian
ObjectiveTo determine agreement of musculoskeletal ultrasound (MSK-US) findings of shoulder pathology and related shoulder special test results in individuals with varied duration of manual wheelchair (MWC) use following spinal cord injury (SCI) and determine if shoulder musculoskeletal impairments, per MSK-US and clinical examination, differed in individuals with SCI and varying duration of MWC use.DesignCross-sectional cohort studySettingLaboratory settingParticipantsTwenty-three adult volunteers with SCI who used a MWC for community mobility. Individuals were stratified into three groups based on duration of MWC use (years): < 5, 5-15, >15.InterventionsNot applicableMain Outcome Measure(s)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.ResultsNo agreement was found between MSK-US and related special tests. Special tests failed to identify impairment in 33.3%-100% of those identified on MSK-US. Total USPRS score was highest in those with >15 years MWC use. Higher proportion of dynamic impingement (supraspinatus and biceps) was found in those >15 years with other MSK-US items having moderate effect sizes among duration use groups.ConclusionsMSK-US identified shoulder impairments more frequently than commonly utilized 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, non-invasive method for determining shoulder impairments and should be used in routine screening of individuals who use a MWC following SCI.



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