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

NCT04712188 | Completed

• 1 other identifier: 10
• Study Type: observational
• Target: 40
• Locations: 1 country
• Sites: 1

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.

Conditions

Traumatic Spinal Cord Injury

Keywords

spinal cord injury; stroke pattern; ultrasonography

Outcome Measures

Primary Outcomes (3)

• Supraspinatus tendon thickness

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

  Through study completion, an average of 1 month

• Long head of the biceps tendon thickness

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

  Through study completion, an average of 1 month

• Acromio-humeral distance

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

  Through study completion, an average of 1 month

Secondary Outcomes (5)

• Shoulder range of motion in the sagittal plane

  Through study completion, an average of 1 month

• Contact angle

  Through study completion, an average of 1 month

• Cadence

  Through study completion, an average of 1 month

• Push phase

  Through study completion, an average of 1 month

• Recovery phase

  Through study completion, an average of 1 month

Study Arms (4)

Arcing

10 patients with traumatic spinal cord injury using the "arcing" stroke pattern to propel manual wheelchair

Diagnostic Test: Musculoskeletal ultrasonography; Other: Wheelchair propelling test

Semicirculer

10 patients with traumatic spinal cord injury using the "semicirculer" stroke pattern to propel manual wheelchair

Diagnostic Test: Musculoskeletal ultrasonography; Other: Wheelchair propelling test

Single loop

10 patients with traumatic spinal cord injury using the "single loop" stroke pattern to propel manual wheelchair

Diagnostic Test: Musculoskeletal ultrasonography; Other: Wheelchair propelling test

Double loop

10 patients with traumatic spinal cord injury using the "double loop" stroke pattern to propel manual wheelchair

Diagnostic Test: Musculoskeletal ultrasonography; Other: Wheelchair propelling test

Interventions

Musculoskeletal ultrasonography DIAGNOSTIC_TEST

The ultrasonographic assesment will be used to examine the supraspinatus tendon thickness, the long head of the biceps brachii tendon thickness and acromio-humeral distance before and after wheelchair propelling test.

Arcing; Double loop; Semicirculer; Single loop

Wheelchair propelling test OTHER

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

Arcing; Double loop; Semicirculer; Single loop

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: male
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Fourty male manual wheelchair users with spinal cord injury, will be divided into 4 groups according to their stroke patterns (arcing, semicirculer, single loop, and double loop).

You may qualify if:

• 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

You may not qualify if:

• 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

Sponsors & Collaborators

• Gaziler Physical Medicine and Rehabilitation Education and Research Hospital: lead

Study Sites (1)

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

Ankara, 06800, Turkey (Türkiye)

Location

Related Publications (1)

• Korkmaz N, Yardimci G, Yilmaz B. Temporospatial parameters, shoulder kinematics, and acute tendon changes in four different stroke patterns in male wheelchair users with spinal cord injury. PM R. 2022 Aug;14(8):939-948. doi: 10.1002/pmrj.12733. Epub 2022 Jan 5.

  PMID: 34741794 DERIVED

MeSH Terms

Conditions

Spinal Cord Injuries

Condition Hierarchy (Ancestors)

Spinal Cord Diseases; Central Nervous System Diseases; Nervous System Diseases; Trauma, Nervous System; Wounds and Injuries

Study Officials

• Nurdan Korkmaz, MD

  Gaziler Physical Medicine and Rehabilitation Education and Research Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Physical Medicine and Rehabilitation Specialist

Study Record Dates

• First Submitted: January 10, 2021
• First Posted: January 15, 2021
• Study Start: June 15, 2020
• Primary Completion: September 30, 2020
• Study Completion: September 30, 2020
• Last Updated: April 30, 2021

Record last verified: 2021-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)