title: Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study.
abstract: BACKGROUND
  Shoulder pain in spinal cord injury (SCI) is common due to the repetition of the wheelchair propulsion and the increased intra-articular pressure during transfers. Known risk factors for the onset of shoulder pain are age and level of SCI. Aims of this study were to assess how body mass index affects the onset of shoulder pain and to evaluate the relationship between the age at the moment of SCI and the number of years between SCI and the onset of shoulder pain.
  
  
  METHODS
  A retrospective study was performed including subjects with SCI between C5 and S3. Excluding criteria were spina bifida and subjects not using manual wheelchair or presenting with shoulder pain before SCI. Patients in the two spinal cord units were reviewed with a self-made questionnaire, and patients were also enrolled during sport events. Age at the moment of SCI, current age and number of years between SCI and the onset of shoulder pain were recorded.
  
  
  RESULTS
  Ninety-six patients were enrolled: 77 men and 19 women; 46.4 % reported shoulder pain. Overweight patients who do more than 12 transfers per day showed an increased incidence of shoulder pain (p = 0.0434). A linear regression showed a significant relationship between the age of the subject at the moment of SCI and the number of years between the SCI and the onset of pain.
  
  
  CONCLUSIONS
  Our study confirms that age and level of SCI are risk factors for shoulder pain, but we demonstrated also that overweight patients who do more than 12 transfers per day have higher chances of having shoulder pain.
authors.affiliation: Department of Orthopaedics and Traumatology Surgery, San Luigi Hospital, University of Torino, Turin, Italy. dottor.gio.gf@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Ferrero
authors.affiliation: Department of Orthopaedics and Traumatology Surgery, San Luigi Hospital, University of Torino, Turin, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Mijno
authors.affiliation: Department of Orthopaedics, Traumatology and Rehabilitation, AO Città della Salute e della Scienza, CTO Hospital, Turin, Italy.
authors.forename: M V
authors.initials: MV
authors.lastname: Actis
authors.affiliation: Spinal Unit, Department of Rehabilitation Medicine, Physical Medicine and Rehabilitation Institute, Udine, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zampa
authors.affiliation: Department of Orthopaedics and Traumatology Surgery, San Luigi Hospital, University of Torino, Turin, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Ratto
authors.affiliation: Department of Orthopaedics and Traumatology Surgery, San Luigi Hospital, University of Torino, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Arpaia
authors.affiliation: Department of Orthopaedics and Traumatology, C.T.O.-Maria Adelaide Hospital, University of Torino, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Massè
mesh_terms: D000328:Adult; D000367:Age Factors; D056352:Athletes; D015992:Body Mass Index; D012090:Cumulative Trauma Disorders / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D020069:Shoulder Pain / Q000209:etiology*; D013119:Spinal Cord Injuries / Q000150:complications*; D013177:Sports; D011795:Surveys and Questionnaires; D014910:Wheelchairs / Q000009:adverse effects*
keywords: Multicenter study; Overuse; Overweight; Shoulder pain; Spinal cord injury; Wheelchair