Journal List > Korean J Sports Med > v.32(1) > 1054524

Lim, Yoo, Lee, Lee, and Kwon: Evaluation of Pain and Ultrasonography on Shoulder in Poliomyelitis Wheelchair Basketball Players

Abstract

The purpose of this study was to determine shoulder pain and shoulder ultrasonographic findings in poliomyelitis Wheelchair Basketball (WB) players. Three physicians performed physical examinations and interviewed WB players about their shoulder pain by using Wheelchair User's Shoulder Pain Index (WUSPI), Performance-Corrected WUSPI (PC-WUSPI), and Shoulder Pain and Disability Index (SPADI). One physician performed shoulder ultrasonography on WB players. All confirmed their International Wheelchair Basketball Federation (IWBF) classifications through Korean Wheelchair Basketball Federation (KWBF). Seventeen men and 6 women players were enrolled in the study, with 46 shoulders evaluated. Nine players had unilateral lower extremity weakness and 14 players were bilateral weakness. Six players used wheelchair for daily living, and 17 players used wheelchair only when playing WB. They were 44.35±5.42 years old on average. They had played WB for 11.09±9.49 years and trained 8.69±3.83 hours a week. PC-WUSPI was significantly correlated with age (p=0.014). There were no significant differences between time spent playing WB, training time for WB, types of poliomyelitis involvement, their use of wheelchair, and WUSPI, PC-WUSPI and SPADI. Tendon tear prevalence was significantly different with training time for WB (p=0.021). Most common abnormal shoulder ultrasonographic findings were subscapularis and supraspinatus tendinopathy. Tendinopathy and tendon tear prevalence did not differ significantly with age, time spent playing WB, types of poliomyelitis, and the use of wheelchair. High prevalence of shoulder pain and rotator cuff pathology were found by physical and ultrasonographic examination in the poliomyelitis wheelchair basketball players. Rotator cuff injury prevention program are needed for prevent shoulder pain and rotator cuff pathology.

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Fig. 1.
Abnormal shoulder ultrasonographic findings.
kjsm-32-20f1.tif
Table 1.
General characteristics of the subjects
Characteristic Total
Number of subjects 23
Male/female 17/6
Age (y) 44.35±5.42
Types of poliomyelitis involvement
  Unilateral 9
  Bilateral 14
Used wheelchair
  Daily living 6
  Only when playing wheelchair basketball 17
  Used gait aid 11/17
Years in wheelchair basketball 11.09±9.49
Hours per week in wheelchair 8.69±3.83
  basketball training

Values were expressed by means±standard deviation.

Table 2.
Correlation of pain and disability index and general characteristics
Characteristics Average Age Wheelchair career Traininng time
R p-value R p-value R p-value
WUSPI 20.30±22.20 0.295 0.172 0.058 0.792 -0.130 0.555
PC-WUSPI 24.31±25.14 0.503 0.014∗ -0.153 0.484 -0.163 0.458
SPADI 30.96±25.60 0.232 0.286 -0.049 0.824 -0.169 0.441

WUSPI: Wheelchair User's Shoulder Pain Index, PC-WUSPI: Performance-Corrected WUSPI, SPADI: Shoulder Pain and Disability Index.

Table 3.
Correlation of pain and disability index and types of poliomyelitis involvement
Characteristic Unilateral involvement Bilateral involvement p-value
WUSPI 5.00 (0−39) 16.50 (0−84) 0.270
PC-WUSPI 8.30 (0−58) 17.55 (0−84) 0.682
SPADI 25.00 (1−67) 22.50 (0−91) 0.925

Values were expressed by median (minimum-maximum). WUSPI: Wheelchair User's Shoulder Pain Index, PC- WUSPI: Performance-Corrected WUSPI, SPADI: Shoulder Pain and Disability Index.

Table 4.
Correlation of pain and disability index and their use of wheelchair
Characteristic Daily living Only when playing wheelchair basketball p-value
WUSPI 12.50 (1-67) 14.00 (0-84) 0.916
PC-WUSPI 9.80 (1-67) 20.60 (0-84) 0.529
SPADI 24.00 (2-75) 25.00 (0-91) 0.753

Values were expressed by median (minimum-maximum). WUSPI: Wheelchair User's Shoulder Pain Index, PCWUSPI: Performance-Corrected WUSPI, SPADI: Shoulder Pain and Disability Index.

Table 5.
Prevalence of shoulder tendinopathy and tear by IWBF classifications
IWBF classifications Class 2.0 Class 2.5 Class 3.0 Class 3.5 Class 4.0 Class 4.5 Total
Tendinopathy 8 7 1 3 1 1 21
Tear 6 6 1 2 2 0 17
Number of subjects 8 7 1 3 3 1 23

IWBF: International Wheelchair Basketball Federation.

Table 6.
Correlation of tendinopathy and general characteristics
Characteristic Tendinopathy + Tendinopathy - p-value Tendon tear + Tendon tear - p-value
Age (y) 45.00 (31−57) 42.00 (36−48) 0.869∗ 45.00 (36−57) 46.50 (31−48) 0.860∗
Wheelchair career 8.00 (1−29) 9.50 (3−16) 1.000∗ 8.00 (1−29) 8.50 (1−27) 0.916∗
Training time 9.00 (3−16) 14.50 (9−20) 0.178∗ 6.00 (3−12) 10.00 (6−20) 0.021∗
Types of involvement 0.142 0.643
  Unilateral 7 2 6 3
  Bilateral 14 0 11 3
Use of wheelchair 1.000 1.000
  For daily living 6 0 5 1
  Only when playing W WB 15 2 12 5

Values were expressed by median (minimum-maximum) in age, wheelchair career, training time. Values were expressed by number of subjects in type of involvement, use of wheelchair. WB: Wheelchair Basketball.∗Result of Mann-Whitney test;

Result of Fisher's exact test.

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