Musculoskeletal Pain Due to Wheelchair Use: A Systematic Review and Meta-Analysis.
Management
Musculoskeletal pain
Risk factors
Wheelchair
Journal
Pain and therapy
ISSN: 2193-8237
Titre abrégé: Pain Ther
Pays: New Zealand
ID NLM: 101634491
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
25
05
2021
accepted:
12
07
2021
pubmed:
14
8
2021
medline:
14
8
2021
entrez:
13
8
2021
Statut:
ppublish
Résumé
Wheelchair users are at a high risk of experiencing non-neuropathic pain of musculoskeletal origin as a result of being wheelchair-bound. The aim of this systematic review was to establish the prevalence of musculoskeletal pain in wheelchair users that is attributable to wheelchair use, and to describe the different pain syndromes and discuss risk factors and management options. After a systematic MEDLINE search, we identified 40 papers eligible for inclusion. The pooled prevalence of musculoskeletal pain at any location was 50% (95% CI 33-67%). The most common pain syndrome was shoulder pain (pooled prevalence 44%, 95% CI 36-52%). Wheelchair users were 5.8 times as likely to suffer from shoulder pain as controls (95% CI 2.7-12.2, p < 0.0001). Other pain syndromes included neck, elbow, wrist, hand and low back pain. Older age and increased duration of wheelchair use were the most significant determinants of pain in wheelchair users. Musculoskeletal pain as a result of wheelchair use is very common amongst wheelchair users. Management of pain should follow national and international guidelines. Optimal adjustment of seating position may prevent pain, and is important to be taken into consideration.
Identifiants
pubmed: 34387846
doi: 10.1007/s40122-021-00294-5
pii: 10.1007/s40122-021-00294-5
pmc: PMC8586284
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
973-984Informations de copyright
© 2021. The Author(s).
Références
Smith EM, Giesbrecht EM, Mortenson WB, et al. Prevalence of wheelchair and scooter use among community-dwelling Canadians. Phys Ther. 2016;96(8):1135–42.
pubmed: 26847009
pmcid: 4992144
doi: 10.2522/ptj.20150574
Liampas A, Velidakis N, Georgiou T, et al. Prevalence and management challenges in central post-stroke neuropathic pain: a systematic review and meta-analysis. Adv Ther. 2020;37(7):3278–91.
pubmed: 32451951
pmcid: 7467424
doi: 10.1007/s12325-020-01388-w
Gutierrez DD, Thompson L, Kemp B, et al. The relationship of shoulder pain intensity to quality of life, physical activity, and community participation in persons with paraplegia. J Spinal Cord Med. 2007;30(3):251–5.
pubmed: 17684891
pmcid: 2031955
doi: 10.1080/10790268.2007.11753933
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.
pubmed: 19621072
pmcid: 2707599
doi: 10.1371/journal.pmed.1000097
Langfelder P, Horvath S. WGCNA: an R package for weighted correlation network analysis. BMC Bioinform. 2008;9:559–559.
doi: 10.1186/1471-2105-9-559
Review Manager (RevMan) [Computer program]. Version 5.4. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.
pubmed: 12111919
doi: 10.1002/sim.1186
Hoy D, Brooks P, Woolf A, et al. Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. J Clin Epidemiol. 2012;65:934–9.
pubmed: 22742910
doi: 10.1016/j.jclinepi.2011.11.014
Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;18(343):d5928.
doi: 10.1136/bmj.d5928
Wells GA, Shea B, O’Connell D et al. The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp . (2008, Assessed 5 Jan 2021)
Sie IH, Waters, Adkins RH, et al. Upper extremity pain in the postrehabilitation spinal cord injured patient. Arch Phys Med Rehabil. 1992;73(1):44–8.
pubmed: 1729973
Pentland WE, Twomey LT. Upper limb function in persons with long term paraplegia and implications for independence: part I. Paraplegia. 1994;32(4):211–8.
pubmed: 8022630
Ortega-Santiago R, González-Aguado ÁJ, Fernández-de-Las-Peñas C, et al. Pressure pain hypersensitivity and referred pain from muscle trigger points in elite male wheelchair basketball players. Braz J Phys Ther. 2020;24(4):333–41.
pubmed: 31383627
doi: 10.1016/j.bjpt.2019.05.008
Rice IM, Jayaraman C, Hsiao-Wecksler ET, et al. Relationship between shoulder pain and kinetic and temporal-spatial variability in wheelchair users. Arch Phys Med Rehabil. 2014;95(4):699–704.
pubmed: 24291595
doi: 10.1016/j.apmr.2013.11.005
Giner-Pascual M, Alcanyis-Alberola M, González LM, et al. Shoulder pain in cases of spinal injury: influence of the position of the wheelchair seat. Int J Rehabil Res. 2011;34(4):282–9.
pubmed: 21971486
doi: 10.1097/MRR.0b013e32834a8fd9
Nawoczenski DA, Ritter-Soronen JM, Wilson CM, et al. Clinical trial of exercise for shoulder pain in chronic spinal injury. Phys Ther. 2006;86(12):1604–18.
pubmed: 17138842
doi: 10.2522/ptj.20060001
Collinger JL, Boninger ML, Koontz AM, et al. Shoulder biomechanics during the push phase of wheelchair propulsion: a multisite study of persons with paraplegia. Arch Phys Med Rehabil. 2008;89(4):667–76.
pubmed: 18373997
doi: 10.1016/j.apmr.2007.09.052
Mercer JL, Boninger M, Koontz A, et al. Shoulder joint kinetics and pathology in manual wheelchair users. Clin Biomech (Bristol, Avon). 2006;21(8):781–9.
doi: 10.1016/j.clinbiomech.2006.04.010
Akbar M, Brunner M, Balean G, et al. A cross-sectional study of demographic and morphologic features of rotator cuff disease in paraplegic patients. J Shoulder Elbow Surg. 2011;20(7):1108–13.
pubmed: 21724421
doi: 10.1016/j.jse.2011.03.021
Mulroy SJ, Hatchett P, Eberly VJ, et al. Shoulder strength and physical activity predictors of shoulder pain in people with paraplegia from spinal injury: prospective cohort study. Phys Ther. 2015;95(7):1027–38.
pubmed: 25721123
pmcid: 4498142
doi: 10.2522/ptj.20130606
Gil-Agudo A, Mozos MS, Crespo-Ruiz B, et al. Shoulder kinetics and ultrasonography changes after performing a high-intensity task in spinal cord injury subjects and healthy controls. Spinal Cord. 2016;54(4):277–82.
pubmed: 26282495
doi: 10.1038/sc.2015.140
Collinger JL, Fullerton B, Impink BG, et al. Validation of grayscale-based quantitative ultrasound in manual wheelchair users: relationship to established clinical measures of shoulder pathology. Am J Phys Med Rehabil. 2010;89(5):390–400.
pubmed: 20407304
pmcid: 2859462
doi: 10.1097/PHM.0b013e3181d8a238
Troy KL, Munce TA, Longworth JA. An exercise trial targeting posterior shoulder strength in manual wheelchair users: pilot results and lessons learned. Disabil Rehabil Assist Technol. 2015;10(5):415–20.
pubmed: 24694062
doi: 10.3109/17483107.2014.905644
Forslund EB, Granström A, Levi R, et al. Transfer from table to wheelchair in men and women with spinal cord injury: coordination of body movement and arm forces. Spinal Cord. 2007;45(1):41–8.
pubmed: 16670685
doi: 10.1038/sj.sc.3101935
Norrbrink C, Lindberg T, Wahman K, et al. Effects of an exercise programme on musculoskeletal and neuropathic pain after spinal cord injury–results from a seated double-poling ergometer study. Spinal Cord. 2012;50(6):457–61.
pubmed: 22289901
doi: 10.1038/sc.2011.160
Silfverskiold J, Waters RL. Shoulder pain and functional disability in spinal cord injury patients. Clin Orthop Relat Res. 1991;272:141–5.
doi: 10.1097/00003086-199111000-00021
Ballinger DA, Rintala DH, Hart KA. The relation of shoulder pain and range-of-motion problems to functional limitations, disability, and perceived health of men with spinal cord injury: a multifaceted longitudinal study. Arch Phys Med Rehabil. 2000;81(12):1575–81.
pubmed: 11128892
doi: 10.1053/apmr.2000.18216
Escobedo EM, Hunter JC, Hollister MC, et al. MR imaging of rotator cuff tears in individuals with paraplegia. AJR Am J Roentgenol. 1997;168(4):919–23.
pubmed: 9124140
doi: 10.2214/ajr.168.4.9124140
Pentland WE, Twomey LT. The weight-bearing upper extremity in women with long term paraplegia. Paraplegia. 1991;29(8):521–30.
pubmed: 1775358
Bayley JC, Cochran TP, Sledge CB. The weight-bearing shoulder. The impingement syndrome in paraplegics. J Bone Jt Surg Am. 1987;69(5):676–8.
doi: 10.2106/00004623-198769050-00006
Deems-Dluhy SL, Jayaraman C, Green S, et al. Evaluating the functionality and usability of two novel wheelchair anti-rollback devices for ramp ascent in manual wheelchair users with spinal cord injury. PM R. 2017;9(5):483–93.
pubmed: 27664403
doi: 10.1016/j.pmrj.2016.09.007
Boninger ML, Cooper RA, Fitzgerald SG, et al. Investigating neck pain in wheelchair users. Am J Phys Med Rehabil. 2003;82(3):197–202.
pubmed: 12595772
doi: 10.1097/01.PHM.0000054217.17816.DD
Kovacs FM, Seco L, Royuela A, et al. Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: a cross-sectional study. Spinal Cord. 2018;56(4):392–405.
pubmed: 29284794
doi: 10.1038/s41393-017-0029-z
Sinnott KA, Milburn P, McNaughton H. Factors associated with thoracic spinal cord injury, lesion level and rotator cuff disorders. Spinal Cord. 2000;38(12):748–53.
pubmed: 11175375
doi: 10.1038/sj.sc.3101095
Tsunoda K, Mutsuzaki H, Hotta K, et al. Correlates of shoulder pain in wheelchair basketball players from the Japanese national team: a cross-sectional study. J Back Musculoskelet Rehabil. 2016;29(4):795–800.
pubmed: 27002664
doi: 10.3233/BMR-160691
Morrow MMB, Van Straaten MG, Murthy NS, et al. Detailed shoulder MRI findings in manual wheelchair users with shoulder pain. Biomed Res Int. 2014;2014:769649.
pubmed: 25180192
pmcid: 4142383
doi: 10.1155/2014/769649
Finley MA, Rodgers MM. Prevalence and identification of shoulder pathology in athletic and nonathletic wheelchair users with shoulder pain: a pilot study. J Rehabil Res Dev. 2004;41(3B):395–402.
pubmed: 15543457
doi: 10.1682/JRRD.2003.02.0022
Samuelsson KAM, Tropp H, Gerdle B. Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users. Spinal Cord. 2004;42(1):41–6.
pubmed: 14713943
doi: 10.1038/sj.sc.3101490
Walford SL, Requejo PS, Mulroy SJ, et al. Predictors of shoulder pain in manual wheelchair users. Clin Biomech (Bristol, Avon). 2019;65:1–12.
doi: 10.1016/j.clinbiomech.2019.03.003
Burnham RS, May L, Nelson E, et al. Shoulder pain in wheelchair athletes. The role of muscle imbalance. Am J Sports Med. 1993;21(2):238–42.
pubmed: 8465919
doi: 10.1177/036354659302100213
Curtis KA, Tyner TM, Zachary L, et al. Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users. Spinal Cord. 1999;37(6):421–9.
pubmed: 10432262
doi: 10.1038/sj.sc.3100860
Wessels KW, Brown JL, Ebersole KT, et al. Sex, shoulder pain, and range of motion in manual wheelchair users. J Rehabil Res Dev. 2013;50(3):351–6.
pubmed: 23881761
doi: 10.1682/JRRD.2011.02.0025
Mason BS, Vegter RJK, Paulson TAW, et al. Bilateral scapular kinematics, asymmetries and shoulder pain in wheelchair athletes. Gait Posture. 2018;65:151–6.
pubmed: 30558924
doi: 10.1016/j.gaitpost.2018.07.170
Samuelsson K, Larsson H, Thyberg M, et al. Wheelchair seating intervention. Results from a client-centred approach. Disabil Rehabil. 2001;23(15):677–82.
pubmed: 11720118
doi: 10.1080/09638280110049900
Kirby RL, Fahie CL, Smith C, et al. Neck discomfort of wheelchair users: effect of neck position. Disabil Rehabil. 2004;26(1):9–15.
pubmed: 14660193
doi: 10.1080/09638280310001621451
Boninger ML, Towers JD, Cooper RA, et al. Shoulder imaging abnormalities in individuals with paraplegia. J Rehabil Res Dev. 2001;38(4):401–8.
pubmed: 11563493
Akbar M, Balean G, Brunner M, et al. Prevalence of rotator cuff tear in paraplegic patients compared with controls. J Bone Jt Surg Am. 2010;92(1):23–30.
doi: 10.2106/JBJS.H.01373
Babatunde OO, Jordan JL, Van der Windt DA, et al. Effective treatment options for musculoskeletal pain in primary care: a systematic overview of current evidence. PLoS ONE. 2017;12(6):e0178621.
pubmed: 28640822
pmcid: 5480856
doi: 10.1371/journal.pone.0178621
Giner-Pascual M, Alcanyis-Alberola M, Querol F, et al. Transdermal nitroglycerine treatment of shoulder tendinopathies in patients with spinal cord injuries. Spinal Cord. 2011;49(9):1014–9.
pubmed: 21537337
doi: 10.1038/sc.2011.41
Mulroy SJ, Thompson L, Kemp B, et al. Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial. Phys Ther. 2011;91(3):305–24.
pubmed: 21292803
doi: 10.2522/ptj.20100182
Wilbanks SR, Rogers R, Pool S, et al. Effects of functional electrical stimulation assisted rowing on aerobic fitness and shoulder pain in manual wheelchair users with spinal cord injury. J Spinal Cord Med. 2016;39(6):645–54.
pubmed: 26449780
pmcid: 5137570
doi: 10.1179/2045772315Y.0000000052