Elbow problems in paraplegic spinal cord injured patients: frequency and related risk factors—a preliminary controlled study

Abstract

Study design: Cross-sectional controlled study. Objectives: To evaluate the elbow joint with ultrasound in paraplegic patients, determine the related factors and compare it with healthy controls. Setting: A training and research rehabilitation hospital in Istanbul. Methods: A total of 30 paraplegic patients and 20 healthy controls were included in the study. Patients demographic data, pain in the elbow joint, level and duration of injury, ambulation status, type of wheelchair used, daily duration of wheelchair and other ambulation equipment usage, transfers being dependent or independent, daily number of push-ups were recorded. Elbow joints were evaluated with ultrasound for presence of fluid and thickness of the triceps tendon. Results: Mean triceps tendon thickness values of the right side were larger in spinal cord injury (SCI) patients when compared with those of healthy controls'. Joint effusion on the right elbow joint was also found to be more common in SCI patients than in normal subjects. Triceps tendon thickness measurements were not found to be correlated with demographic and clinical factors. Seven paraplegic patients (23%) reported that they have pain in the elbow. Conclusion: In this preliminary study, our results showed that right elbow effusion was more frequent and right triceps tendon was thicker in SCI patients when compared with healthy subjects.

Prevalence of upper extremity pain in a population of people with paraplegia

“…Similar rates have been reported by Dalyan et al and Pentland et al (35% and 31%,respectively) [21,24]. In other studies, the prevalence is reported as 5-23% [4,20,23]. Elbow pain associated with chronic overuse has been widely studied in the able-bodied population, and its most common pathology is lateral epicondylitis (i.e., tennis elbow) [44] and it occurs in those who frequently perform forceful and repetitive movements [45].…”

“…Although pathological conditions of the shoulder and wrist joints in individuals with paraplegia who are wheelchair dependent have been extensively studied [3,[13][14][15][16][17][18][19], only a few studies focused on the prevalence of elbow pain and its etiologies [20][21][22]. Several previous studies have focused primarily on the prevalence of wrist pain.…”

Network analysis of multimorbidity and health outcomes among persons with spinal cord injury in Canada

“…Shoulder problems can be caused by acute injury or chronic pathology, but are most often related to overuse injuries of the rotator cuff (36)(37)(38). Whereas for elbow/wrist problems, the elbow joint is often overused particularly during push-up manoeuvres required for both weight shifts and transfers (39). Both elbow/wrist and shoulder problems can significantly negatively affect a person's health and function; thus, this significant association between elbow/wrist problems and shoulder problems can enable clinicians to identify these injuries earlier, and employ treatment and/or preventive strategies to preserve shoulder and elbow function after SCI.…”