Clinical trial NCT06278740: Upper Extremity Pathologies in Spinal Cord Injuries
Official title: Investigation of Upper Extremity Pathologies and Associated Factors in Patients With Spinal Cord Injuries
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Spinal Cord Injuries
Upper Extremity Problem
Musculoskeletal Pain
Lead sponsor: Afyonkarahisar Health Sciences University
Sponsor class: OTHER
First posted: 2024-02-26
Enrollment: 174
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Spinal cord injuries who use manual wheelchairs and spinal cord injuries who do not use manual wheelchairs, aged between 18-65 years who applied to our clinic will be included in the study.

Brief summary: This study aims to determine the relationship between upper extremity pathologies and demographic data, duration of manual wheelchair use, duration of injury, physical examination and musculoskeletal ultrasound measurements in patients with spinal cord injuries.

Detailed description: Spinal cord injury is a neurological condition that can result from traumatic or non-traumatic causes, leading to motor, sensory and autonomic dysfunctions. Following a spinal cord injury, the upper extremity becomes increasingly used for mobility, weight-bearing, and transfer activities, making functionality crucial in daily life. Wheelchairs, commonly used by individuals with spinal cord injuries for daily activities, can lead to injuries and pain or degeneration in the upper extremities due to repetitive transfer activities. As a result, individuals with spinal cord injuries are at high risk for shoulder, elbow, wrist and hand injuries. Neuromuscular ultrasound (NMUS) has become increasingly important in clinical use in the evaluation of peripheral nerves and muscles in patients with spinal cord injuries in recent years, due to the advantages of ultrasonography such as providing dynamic and real-time evaluation, not containing radiation, and being painless.

This study aims to determine the relationship between upper extremity pathologies and demographic data, duration of manual wheelchair use, duration of injury, physical examination and musculoskeletal ultrasound measurements in patients with spinal cord injuries.

Eligibility criteria: Inclusion Criteria:

* Patients who have experienced spinal cord injury, can comply with two-stage verbal commands, voluntarily agree to participate in the study and are medically stable.

Exclusion Criteria:

* Tetraplegia
* A significant comorbid condition such as severe heart disease and uncontrolled hypertension.
* Cognitive dysfunction
* Active infection
* Malignancy
* History of trauma to the upper extremity
* Brachial plexus and peripheral nerve injury
* History of surgery on the upper extremity

Primary outcomes:
measure: Comparison of US findings among participants
timeFrame: 1 day (a single point in time)
Secondary outcomes:
measure: Visual Analog Scale (VAS)
timeFrame: 1 day (a single point in time)
measure: The Physical Examination of the Shoulder Scale (PESS)
timeFrame: 1 day (a single point in time)
measure: The Quick Disability of the Arm, Shoulder, and Hand (Quick DASH)
timeFrame: 1 day (a single point in time)
measure: American Spinal Injury Association (ASIA) Impairment Scale
timeFrame: 1 day (a single point in time)
measure: The Spinal Cord Independence Measure (SCIM-III)
timeFrame: 1 day (a single point in time)
Other outcomes:
Locations:
city: Afyonkarahisar
country: Turkey
facility: Afyonkarahisar
city: Afyonkarahisar
country: Turkey
facility: Afyonkarahisar Health Sciences University
Study officials:
affiliation: Afyonkarahisar Health Sciences University
name: Mahmut Sami DOĞANLAR, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Afyonkarahisar Health Sciences University
name: Nuran EYVAZ, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Ata AM, Mete Civelek G, Kara O. Relationship Between Manual Wheelchair Using Skills and Upper Limb Musculoskeletal Disorders in Patients With Spinal Cord Injury: A Musculoskeletal Ultrasonography Study. Am J Phys Med Rehabil. 2023 Nov 1;102(11):959-964. doi: 10.1097/PHM.0000000000002296. Epub 2023 May 23.
citation: Collinger JL, Fullerton B, Impink BG, Koontz AM, Boninger ML. Validation of grayscale-based quantitative ultrasound in manual wheelchair users: relationship to established clinical measures of shoulder pathology. Am J Phys Med Rehabil. 2010 May;89(5):390-400. doi: 10.1097/PHM.0b013e3181d8a238.
citation: Vives Alvarado JR, Felix ER, Gater DR Jr. Upper Extremity Overuse Injuries and Obesity After Spinal Cord Injury. Top Spinal Cord Inj Rehabil. 2021;27(1):68-74. doi: 10.46292/sci20-00061.