Evaluation of Pain and Ultrasonography on Shoulder in Poliomyelitis Wheelchair Basketball Players

Kil-Byung Lim; Jeehyun Yoo; Hong-Jae Lee; Ji Heoung Lee; Yong-Geol Kwon

doi:10.5763/kjsm.2014.32.1.20

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

Clinical Article

Korean J Sports Med 2014;32(1):20-26.

Published online: 17 January 2014

DOI: https://doi.org/10.5763/kjsm.2014.32.1.20

Evaluation of Pain and Ultrasonography on Shoulder in Poliomyelitis Wheelchair Basketball Players

Kil-Byung Lim, Jeehyun Yoo, Hong-Jae Lee, Ji Heoung Lee, Yong-Geol Kwon

Department of Rehabilitation Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Korea

Correspondence: Ji Heoung Lee Department of Rehabilitation Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, 170 Juhwa-ro, Ilsanseo-gu, Goyang 411-706, Korea Tel: +82-31-910-7114, Fax: +82-31-910-7746, E-mail: lejihy8005@daum.net

Received 3 March 2014 Revised 9 May 2014 Accepted 13 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Poliomyelitis, Wheelchair basketball, Shoulder pain, Ultrasonography

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Fig. 1.

Abnormal shoulder ultrasonographic findings.

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
Characteristics	Average	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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