Progression of rotator cuff tendon pathology in manual wheelchair users with spinal cord injury: A 1-year longitudinal study.
Progression of rotator cuff tendon pathology in manual wheelchair users with spinal cord injury: A 1-year longitudinal study.
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DOI：
10.1080/10790268.2022.2057720
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发表时间：
2023-05
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影响因子：
--
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中科院分区：
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--
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目的：研究手动轮椅（MWC）脊髓损伤（SCI）患者及相应的健康人一年内肩袖肌腱病变的进展情况，并探讨疼痛、年龄和轮椅使用时间与肩袖病变进展的关系。设计：纵向队列研究，随访1年。地点：三级医疗中心门诊。参与者：24名患有SCI的成年MWC使用者（20名男性），平均年龄（SD）为37（12）岁，24名年龄和性别匹配的健全个体。干预措施：不适用。主要结果测量：收集肩痛的存在情况。基线和1年随访时的肩袖肌腱的磁共振成像（MRI）异常，包括肌腱病变和肌腱撕裂，由委员会认证的肌肉骨骼放射科医生评分，并计算每个参与者的三种肌腱病理评分，包括单个肌腱评分、单侧袖带评分和双侧袖带评分。结果：54%的MWC使用者在两个时间点报告肩膀疼痛，显著高于基线（17%,P = 0.012）和第一年（21%,P = 0.021）的健全队列。在两个时间点，两个队列中均检测到肩袖肌腱病理主要为轻度肌腱病变和低级别部分厚度撕裂，但在MWC使用者中更为常见。双侧袖带评分结果显示MWC使用者一年内肩袖肌腱病理进展显著（P < 0.008）。在身体健全的人群中，MRI结果没有明显变化。在MWC使用者队列中，疼痛、年龄或MWC使用时间与肩袖病理进展没有关联。结论：MWC使用者的疼痛患病率高于匹配的健全队列，但疼痛是最小的，不限制功能。双侧袖带TOTAL评分显示MWC使用者的病理进展，但MRI结果在健全队列中保持稳定。MWC使用者经历病理进展的可能性是健全人群的3.4倍。
Objective: To investigate the progression of rotator cuff tendon pathology across one year in manual wheelchair (MWC) users with spinal cord injury (SCI) and matched able-bodied individuals, and to explore the association between pain, age, and duration of wheelchair use with the progression of rotator cuff pathology. Design: Longitudinal cohort study, 1-year follow-up. Setting: Outpatient clinic at a tertiary medical center. Participants: Twenty-four adult MWC users with SCI (20 men) with an average age (SD) of 37(12) years and 24 age and sex-matched able-bodied individuals. Interventions: Not applicable. Main outcome measure(s): Presence of shoulder pain was collected. Magnetic resonance imaging (MRI) abnormalities of rotator cuff tendons including tendinopathy and tendon tears at baseline and 1-year follow-up visits were graded by a board-certified musculoskeletal radiologist, and three categories of tendon pathology scores including individual tendon scores, unilateral cuff scores, and bilateral cuff scores were calculated for each participant. Results: Fifty-four percent of the MWC users reported shoulder pain at both time points which was significantly higher than able-bodied cohort at baseline (17%, P = 0.012) and year 1 (21%, P = 0.021). Rotator cuff tendon pathology was detected as mainly mild tendinopathies and low-grade partial-thickness tears in both cohorts at both time points but was more common in MWC users. The results for the bilateral cuff scores indicated a significant (P < 0.008) progression of rotator cuff tendon pathology in the MWC users over one year. MRI findings did not change significantly for the able-bodied cohort across time. There was no association of pain, age, or duration of MWC use with progression of rotator cuff pathology in MWC user cohort. Conclusion: MWC users had a higher prevalence of pain than matched able-bodied cohort, but pain was minimal and not function-limiting. Bilateral cuff TOTAL scores showed pathology progression in MWC users, but MRI findings remained stable in the able-bodied cohort. MWC users were 3.4 times more likely to experience pathology progression than the able-bodied cohort.
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