## 4 Results  
Nineteen male athletes were enrolled in the study. Three athletes were absent on the days in which the WSTs were repeated, after one year, and were excluded from the statistical analysis. None of the participants reported acute musculoskeletal injuries during the study period.  
Sixteen subjects were finally included (mean age \(\pm\) SD: 33 \(\pm\) 7 years old; age of SCI \(\pm\) SD: 17.3 \(\pm\) 7.1 years; time of disability \(\pm\) SD: 16 \(\pm\) 7 years; mean BMI \(\pm\) SD: 22.2 \(\pm\) 3.8 kg/m; number of daily transfers \(\pm\) SD, 13.3 \(\pm\) 2.5) (Table 1). All athletes were right-handed except for two. SCI level ranged from C5 to C8; the most common level of injury was C6 (five participants). Eight patients had complete SCI (AIS A), while eight patients had incomplete SCI (seven AIS B, one AIS C). The IWRFC score was: four athletes, 0.5 points; six athletes, 1.0 point; and six athletes, 1.5 points. All participants used a defensive wheelchair rugby chair whose weight was 16.1 \(\pm\) 2.3 kg.  
Eleven athletes reported shoulder pain during daily activities and only three complained of slight pain before the WST: two athletes for both shoulders and one only for the dominant shoulder; mean VAS score was 1.8 \(\pm\) 0.4 SD. None of the participants had taken painkillers in the days before the WST.  
\begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Participant** & **Age** & **BMI** & **AIS Score** & **Years of Disability** & **IWRFC** \\ \hline
1 & 36 & 18 & AC4 & 17 & 1 \\
2 & 33 & 19.7 & AC7 & 17 & 1 \\
3 & 29 & 24 & BC7 & 27 & 1.5 \\
4 & 43 & 21.5 & AC4 & 27 & 1 \\
5 & 29 & 23.3 & AC6 & 10 & 0.5 \\
6 & 42 & 20.7 & BC7 & 14 & 1.5 \\
7 & 27 & 18 & AC6 & 7 & 1 \\
8 & 37 & 24.4 & BC7 & 12 & 1.5 \\
9 & 30 & 17.3 & BC5 & 19 & 0.5 \\
10 & 25 & 19.4 & CC6 & 7 & 1 \\
11 & 33 & 19.6 & AC5 & 15 & 1 \\
12 & 27 & 25.9 & BC8 & 8 & 1.5 \\
13 & 42 & 23.7 & AC8 & 23 & 0.5 \\
14 & 47 & 27.1 & BC6 & 7 & 1.5 \\
15 & 40 & 31.6 & BC6 & 20 & 1.5 \\
16 & 23 & 21.1 & AC8 & 23 & 0.5 \\ \hline \hline \end{tabular}
\end{table}
Table 1: Subject characteristics. BMI: body mass index. AIS: American Spinal Injury Association Impairment Scale. IWRFC: International Wheelchair Rugby Federation Classification.  
Figure 2: Representation of the 30 m figure-of-eight sprint circuit’s trajectory from the start to the finish line.  
Bicipital tenderness was found in 42.3% of the athletes, greater tuberosity/supraspinatus tenderness in 15.3%, acromiolacicular joint pain in 7.7%, the Hawkins-Kennedy impingement sign was positive in 3.8% of the subjects, the presence of a painful arc in 7.7%, the Jobe's test in 3.8%, the O'Brien test for the labrum in 11.5%m and the O'Brien test for the acromiolacicular joint in 7.7%. The other physical pathologic signs were absent.  
Mean (\(\pm\)SD) PES was 2.5 (\(\pm\)2.8) for the dominant shoulder, and 1.3 (\(\pm\)1.6) for the non-dominant shoulder. The dominant/non-dominant PESS difference was not statistically significant with a Mann-Whitney U test (\(p\) = 0.712).  
The shoulder ultrasound examination results are shown in Figure 3.  
Mean (\(\pm\)SD) USPRS score was 2.3 (\(\pm\)3.1) for the dominant shoulder, and 2.1 (\(\pm\)2.1) for the non-dominant shoulder. The dominant/non-dominant USPRS score difference was not statistically significant (\(p\) = 0.712).  
The mean 20 m sprint test time was 7.94 s (range: 6.74-10.72 s) at baseline and 7.92 (6.53-10.33 s) after one year, and there was not a statistically significant difference between these results with a Mann-Whitney U test (\(p\) = 0.74). The correlation at [PERSON]'s rank correlation test was significant (\(p\) = 0.89 \(p\) = 0.0002).  
The mean 30 m figure-of-eight sprint time was 11.7 s (range: 10.65-16.51 s) at baseline and 10.97 (9.38-13.83 s) after one year. The Mann-Whitney U test result was not significant (\(p\) = 0.19); the [PERSON]'s test results were significant (\(p\) = 0.709; \(p\) = 0.014).  
The correlations between age, BMI, PESS, USPRS and WST are shown in Tables 2-4.  
Figure 3: Shoulder ultrasound findings.