Changes in supraspinatus and biceps tendon thickness: influence of fatiguing propulsion in wheelchair users with spinal cord injury

Spinal Cord, 2020 · DOI: 10.1038/s41393-019-0376-z · Published: March 1, 2020

Spinal Cord Injury Assistive Technology Musculoskeletal Medicine

Simple Explanation

This study investigates how the tendons in the shoulder change after wheelchair users with spinal cord injuries experience fatigue from propelling their wheelchairs. Researchers measured the thickness and appearance of the supraspinatus and biceps tendons before and after a fatiguing wheelchair propulsion activity. The study found that the supraspinatus tendon, which is important for shoulder function, becomes thinner after the wheelchair users experienced fatigue.

Study Duration

Not specified

Participants

50 wheelchair users with SCI at lesion level T2 or below

Evidence Level

Quasi-experimental, pretest-posttest design

Key Findings

1
A reduction in supraspinatus tendon thickness after fatiguing wheelchair propulsion was identified.
2
Females who fatigued displayed a greater reduction in supraspinatus tendon thickness as compared to those who did not fatigue.
3
Higher body weight was associated with an increase in supraspinatus tendon thickness.

Research Summary

This study investigated acute changes in the supraspinatus and biceps tendon following fatiguing wheelchair propulsion in persons with spinal cord injury (SCI). The study identified a significant reduction in supraspinatus tendon thickness after fatiguing wheelchair propulsion, particularly in females who fatigued. Body weight and acromio-humeral distance (AHD) were found to be associated with changes in tendon thickness, suggesting potential factors influencing tendon health in this population.

Practical Implications

Informing Training Strategies

The findings can help define training strategies that improve mechanical and material properties of tendons and subsequently reduce injury risk.

Understanding Tendinopathy Etiology

Understanding the etiology and development of tendinopathy in SCI can be improved by considering acute changes in tendon appearance with repetitive wheelchair activity and its association to risk factors.

Personalized Interventions

Identifying characteristics that predispose an individual to pathological tendon changes is a first step to tailor interventions, improve load management and limit progression of tendinopathy.

Study Limitations

1
Results cannot be generalized to the entire study population based on our exclusion criteria as for example pain limiting the ability to propel.
2
The reported use of drugs to treat upper limb pain in 8 of the participants should be acknowledged and may have affected the results.
3
The intervention includes overground propulsion, it remains artificial and may not represent daily-life activities of wheelchair users.

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