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Shoulder Kinematics and Acute Ultrasonographic Changes in Manual Wheelchair Users With Spinal Cord Injury

Completed
Conditions
Traumatic Spinal Cord Injury
Interventions
Diagnostic Test: Musculoskeletal ultrasonography
Other: Wheelchair propelling test
Registration Number
NCT04712188
Lead Sponsor
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Brief Summary

People who lose function of the lower limb due to spinal cord injury (SCI) need to use their arms for activities of daily life especially during weight-bearing tasks, such as transfers, and manual wheelchair (MWC) propulsion in order to maintain mobility. Persistent use of the upper limbs constitutes biomechanical difficulties, especially in the shoulder joint. The most commonly affected area in the shoulder is supraspinatus and biceps tendon. Four different stoke patterns have been classified in MWC users. Distinct amounts of force may be applied to the shoulder joint during propulsion with different stroke patterns and this can affect the shoulder tendons in different rates. In this study, investigators aimed to evaluate and compare the acute sonographic changes in supraspinatus and biceps tendons after a wheelchair propelling test in MWC users with SCI with different stroke patterns. Also, it is intended to determine the risk factors related to the stroke patterns that may be associated with these sonographic changes.

Detailed Description

Fourty male MWC users with SCI were will be divided into 4 groups according to their stroke patterns (arcing, semicirculer, single loop, and double loop). Participants will use their own wheelchairs with their preferred stroke pattern for 20 minutes at a speed of 1 m / s on a motorized treadmill for a wheelchair propelling test. Wheelchair propelling videos will be recorded during the test. Shoulder kinematics will be analyzed using Kinovea motion analysis software and stoke pattern will be confirmed. Ultrasonographic assesment of participants' nondominant shoulder will be performed before and after testing procedure.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
40
Inclusion Criteria
  • People with traumatic spinal cord injury
  • Age between 18 to 65 years,
  • Neurologic injury level at T2 or below, with AIS grade A or B,
  • Time since injury at least 6 months,
  • Using manual wheelchair as their primary mobility tools
Exclusion Criteria
  • Fractures in nondominant upper limb at any time,
  • Shoulder surgery within the past 5 years or corticosteroid injections within the past 3 months to the nondominant shoulder,
  • Upper limb pain that restricts propulsion of a manual wheelchair,
  • A history of cardiopulmonary problems and degenerative joint diseases

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Double loopMusculoskeletal ultrasonography10 patients with traumatic spinal cord injury using the "double loop" stroke pattern to propel manual wheelchair
SemicirculerMusculoskeletal ultrasonography10 patients with traumatic spinal cord injury using the "semicirculer" stroke pattern to propel manual wheelchair
Single loopWheelchair propelling test10 patients with traumatic spinal cord injury using the "single loop" stroke pattern to propel manual wheelchair
ArcingWheelchair propelling test10 patients with traumatic spinal cord injury using the "arcing" stroke pattern to propel manual wheelchair
SemicirculerWheelchair propelling test10 patients with traumatic spinal cord injury using the "semicirculer" stroke pattern to propel manual wheelchair
Single loopMusculoskeletal ultrasonography10 patients with traumatic spinal cord injury using the "single loop" stroke pattern to propel manual wheelchair
Double loopWheelchair propelling test10 patients with traumatic spinal cord injury using the "double loop" stroke pattern to propel manual wheelchair
ArcingMusculoskeletal ultrasonography10 patients with traumatic spinal cord injury using the "arcing" stroke pattern to propel manual wheelchair
Primary Outcome Measures
NameTimeMethod
Supraspinatus tendon thicknessThrough study completion, an average of 1 month

Transverse images of the suprasinatus tendon will be performed by using musculoskeletal ultrasonography before and after the wheelchair propelling test

Long head of the biceps tendon thicknessThrough study completion, an average of 1 month

Longitudinal images of the long head of the biceps tendon will be performed by using musculoskeletal ultrasonography before and after the wheelchair propelling test

Acromio-humeral distanceThrough study completion, an average of 1 month

Acromio-humeral distance measurements will be performed by using musculoskeletal ultrasonography before and after the wheelchair propelling test

Secondary Outcome Measures
NameTimeMethod
Push phaseThrough study completion, an average of 1 month

Push phase (time elapsed since the handrim is held until it is released, second) will be analyzed using by Kinovea version 0.8.27 motion analysis software.

Shoulder range of motion in the sagittal planeThrough study completion, an average of 1 month

Shoulder range of motion in the sagittal plane (flexion and extension, degree) will be analyzed using by Kinovea version 0.8.27 motion analysis software.

CadenceThrough study completion, an average of 1 month

Cadence (number of strokes per minute, stroke number/minute) will be analyzed using by Kinovea version 0.8.27 motion analysis software.

Contact angleThrough study completion, an average of 1 month

Contact angle (angle at which the handrim is held, degree) will be analyzed using by Kinovea version 0.8.27 motion analysis software.

Recovery phaseThrough study completion, an average of 1 month

Recovery phase (time elapsed since the handrim is released until it is held again, second) will be analyzed using by Kinovea version 0.8.27 motion analysis software.

Trial Locations

Locations (1)

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

🇹🇷

Ankara, Turkey

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