title: Shoulder ultrasound abnormalities, physical examination findings, and pain in manual wheelchair users with spinal cord injury.
abstract: OBJECTIVE
  To investigate the presence of ultrasound (US) abnormalities in manual wheelchair users with spinal cord injury (SCI) using a quantitative Ultrasound Shoulder Pathology Rating Scale (USPRS). To investigate physical examination (PE) findings using a quantitative Physical Examination of the Shoulder Scale (PESS), and to obtain data about pain and other subject characteristics such as age, years with SCI, and weight.
  
  
  METHODS
  Case series.
  
  
  METHODS
  National Veterans' Wheelchair Games 2005 and 2006.
  
  
  METHODS
  Volunteer sample of manual wheelchair users with SCI participating in the National Veterans' Wheelchair Games.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Presence of relationships between US findings, PE findings, pain, and subject characteristics.
  
  
  RESULTS
  The USPRS correlated with age, duration of SCI, and weight (all P<.01), and showed a positive trend with the total Wheelchair User's Shoulder Pain Index (WUSPI) score (r=.258, P=.073). Several US findings related to presence of PE findings for specific structures. The PESS score correlated with the WUSPI (r=.679, P<.001) and duration of SCI (P<.05). The presence of untreated shoulder pain that curtailed activity was noted in 24.5% of subjects, and this was related to increased WUSPI scores (P=.002).
  
  
  CONCLUSIONS
  PE and US abnormalities are common in manual wheelchair users with SCI. The USPRS and PESS demonstrated evidence for external validity and hold promise as research tools. Untreated shoulder pain is common in manual wheelchair users with SCI, and further investigation of this pain is indicated.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. brosesw@upmc.edu
authors.forename: Steven W
authors.initials: SW
authors.lastname: Brose
authors.forename: Michael L
authors.initials: ML
authors.lastname: Boninger
authors.forename: Bradley
authors.initials: B
authors.lastname: Fullerton
authors.forename: Thane
authors.initials: T
authors.lastname: McCann
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Collinger
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Impink
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Dyson-Hudson
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012307:Risk Factors; D017006:Rotator Cuff / Q000000981:diagnostic imaging; D000070636:Rotator Cuff Injuries; D020069:Shoulder Pain / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D016037:Single-Blind Method; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D014463:Ultrasonography; D014481:United States; D014728:Veterans; D014910:Wheelchairs / Q000009:adverse effects