title: Prevalence of shoulder discomfort in paraplegic subjects.
abstract: BACKGROUND
  The annual incidence of acute spinal cord injury, as reported in the National Spinal Cord Injury Statistical Center, was estimated to be approximately 40 cases per million, or approximately 11.000 new cases in the United States each year (1). In subjects with spinal cord injury, overstress of the upper extremities occurs not only during daily life activities, but also utilizing wheelchair. The aim of this study is to determine the prevalence of shoulder discomfort in subjects affected by paraplegia living in our country area and evaluate the associated risk factors negatively affecting the shoulder function.
  
  
  METHODS
  A computerized database search for paraplegic patients was performed at the Department of Orthopedic Surgery, Trauma Surgery and Rehabilitation Medicine. Among the 54 selected paraplegic patients, 47 accepted to participate at the study. Once the patients were contacted, the medical records were reviewed to obtain information regarding shoulder, elbow and spine region pain and discomfort.
  
  
  RESULTS
  The 60% of all the patients who answered to the questionnaire complain shoulder pain, 90% bilaterally, and the 30% referred elbow pain, 20% bilaterally. 77% complains back pain, involving particularly lumbar region. Only 2% of this population undergoes a shoulder surgery treatment for cuff tear and shoulder disability.
  
  
  CONCLUSIONS
  The present study is the first in our country that gives an overview of prevalence of upper limb discomfort in paraplegic patients. We have shown the interplay between shoulder elbow and spine with pain, age of patients and type of wheel chair utilized. The previous factors can be corrected and upper limb discomfort relieved.
authors.affiliation: Unit of Shoulder and Elbow surgery, D. Cervesi Hospital, Cattolica (Italy); 2 Orthopedic Clinic, University of Parma, Parma, Italy. a.pellegrini@aol.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Pellegrini
authors.forename: Francesco
authors.initials: F
authors.lastname: Pegreffi
authors.forename: Paolo
authors.initials: P
authors.lastname: Paladini
authors.forename: Michele Arcangelo
authors.initials: MA
authors.lastname: Verdano
authors.forename: Francesco
authors.initials: F
authors.lastname: Ceccarelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Porcellini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications*; D015995:Prevalence; D012307:Risk Factors; D020069:Shoulder Pain / Q000453:epidemiology*; D013119:Spinal Cord Injuries / Q000150:complications*; D013904:Thoracic Vertebrae; D014910:Wheelchairs