Shoulder pain in wheelchair users with tetraplegia and paraplegia

Objective: To compare the prevalence and intensity of shoulder pain experie nced during daily functional activities in individuals with tetraplegia and individuals with paraplegia who use manual wheelchairs. Design: Self-report survey. Setting: General community. Participants: Fifty-five women and 140 men, 92 subjects with tetraplegia an d 103 subjects with paraplegia who met inclusion criteria of 3 hours per we ek of manual wheelchair use and at least I year since onset of spinal cord injury. Main Outcome Measures: Respondents completed a demographic and medical hist ory questionnaire and the Wheelchair User's Shoulder Pain Index (WUSPI), a measure of pain during typical daily activities. Results: More than two thirds of the sample reported shoulder pain since be ginning wheelchair use, with 59% of the subjects with tetraplegia and 42% o f the subjects with paraplegia reporting current pain. Performance-correcte d WUSPI scores were significantly higher in subjects with tetraplegia than in subjects with paraplegia, Conclusions: Both the prevalence and intensity of shoulder pain was signifi cantly higher in subjects with tetraplegia than in subjects with paraplegia . Efforts to monitor and prevent shoulder pain should continue after rehabi litation. (C) 1999 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.