Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury
Upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using persons with a spinal cord injury
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DOI：
10.1038/sj.sc.3101826
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发表时间：
2006-03-01
期刊：
影响因子：
2.2
通讯作者：
van der Woude, LHV
中科院分区：
文献类型：
--
作者：
van Drongelen, S;de Groot, S;van der Woude, LHV
研究设计：前瞻性队列研究。目的：研究脊髓损伤（SCI）患者使用轮椅康复期间和康复后的上肢肌肉骨骼疼痛及其与病变特征、肌肉力量和功能结果的关系。设置：荷兰8个SCI康复中心。方法：使用问卷调查，测量上肢肌肉骨骼疼痛投诉的数量、频率和严重性。腕关节、肘关节和肩关节的疼痛评分通过将严重程度乘以疼痛主诉的频率来计算。将双上肢三个关节的评分相加，得到总分。通过手动肌肉测试确定肌肉力量。功能独立性测量的运动评分提供了功能结果。所有结果均在康复期间和1年后的4个测试场合获得。结果：上肢疼痛和肩部疼痛随着时间的推移而减少（30%），在住院患者康复的后期（P < 0.001）。四肢瘫患者的肌肉骨骼疼痛程度明显高于截瘫患者（P < 0.001）。上肢疼痛和肩部疼痛与功能结局呈显著负相关（P < 0.001）。肌力与肩痛呈显著负相关（P < 0.001）。康复治疗开始时的肌肉骨骼疼痛和BMI是住院康复治疗后1年疼痛的强预测因子（P < 0.001）。结论：TP受试者上肢肌肉骨骼疼痛和肩部疼痛的风险高于PP受试者。较高的肌肉力量和较高的功能结果与较少的上肢投诉有关。
Study design: Prospective cohort study.Objectives: To study upper extremity musculoskeletal pain during and after rehabilitation in wheelchair-using subjects with a spinal cord injury (SCI) and its relation with lesion characteristics, muscle strength and functional outcome.Setting: Eight rehabilitation centers with an SCI unit in the Netherlands.Methods: Using a questionnaire, number, frequency and seriousness of musculoskeletal pain complaints of the upper extremity were measured. A pain score for the wrist, elbow and shoulder joints was calculated by multiplying the seriousness by the frequency of pain complaints. An overall score was obtained by adding the scores of the three joints of both upper extremities. Muscle strength was determined by manual muscle testing. The motor score of the functional independence measure provided a functional outcome. All outcomes were obtained at four test occasions during and 1 year after rehabilitation.Results: Upper extremity pain and shoulder pain decreased over time (30%) during the latter part of in-patient rehabilitation (P < 0.001). Subjects with tetraplegia (TP) showed more musculoskeletal pain than subjects with paraplegia (PP) (P < 0.001). Upper extremity pain and shoulder pain were significantly inversely related to functional outcome (P < 0.001). Muscle strength was significantly inversely related to shoulder pain (P < 0.001). Musculoskeletal pain at the beginning of rehabilitation and BMI were strong predictors for pain 1 year after in-patient rehabilitation (P < 0.001).Conclusions: Subjects with TP are at a higher risk for upper extremity musculoskeletal pain and for shoulder pain than subjects with PP. Higher muscle strength and higher functional outcome are related to fewer upper extremity complaints.