Clinical trial NCT04712188: Shoulder Kinematics and Acute Ultrasonographic Changes in Manual Wheelchair Users With Spinal Cord Injury
Official title: Shoulder Kinematics and Acute Ultrasonographic Changes in Four Different Stroke Patterns in Manual Wheelchair Users With Spinal Cord Injury
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Traumatic Spinal Cord Injury
Keywords: spinal cord injury
stroke pattern
ultrasonography
Lead sponsor: Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Sponsor class: OTHER
First posted: 2021-01-15
Enrollment: 40
Sex: MALE
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Observational model: OTHER
Time perspective: PROSPECTIVE
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).

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.

Detailed description: Fourty male MWC users with SCI were will be divided into 4 groups according to their stroke patterns (arcing, semicirculer, single loop, and double loop). 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. Ultrasonographic assesment of participants' nondominant shoulder will be performed before and after testing procedure.

Eligibility criteria: Inclusion Criteria:

* 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

Exclusion Criteria:

* 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

Primary outcomes:
measure: Supraspinatus tendon thickness
timeFrame: Through study completion, an average of 1 month
measure: Long head of the biceps tendon thickness
timeFrame: Through study completion, an average of 1 month
measure: Acromio-humeral distance
timeFrame: Through study completion, an average of 1 month
Secondary outcomes:
measure: Shoulder range of motion in the sagittal plane
timeFrame: Through study completion, an average of 1 month
measure: Contact angle
timeFrame: Through study completion, an average of 1 month
measure: Cadence
timeFrame: Through study completion, an average of 1 month
measure: Push phase
timeFrame: Through study completion, an average of 1 month
measure: Recovery phase
timeFrame: Through study completion, an average of 1 month
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Study officials:
affiliation: Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
name: Nurdan Korkmaz, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.