Although shoulder pain is a problem in up to 86% of persons with a spinal cord injury (SCI), so far, no studies have empirically identified longitudinal patterns (trajectories) of musculoskeletal shoulder pain after SCI. The objective of this study was: (1) to identify distinct trajectories of musculoskeletal shoulder pain in persons with SCI, and (2) to determine possible predictors of these trajectories. Multicenter, prospective cohort study in 225 newly injured persons with SCI. Shoulder pain was assessed on five occasions up to 5 years after discharge. Latent class growth mixture modeling was used to identify the distinct shoulder pain trajectories. Three distinct shoulder pain trajectories were identified: (1) a "No or Low pain" trajectory (64%), (2) a "High pain" (30%) trajectory, and (3) a trajectory with a "Decrease of pain" (6%). Compared with the "No or Low pain" pain trajectory, the "High pain" trajectory consisted of more persons with tetraplegia, shoulder pain before injury, limited shoulder range of motion (ROM), lower manual muscle test scores, or more spasticity at t1. Multiple logistic regression analysis showed two significant predictors for the "High pain" trajectory (as compared with the "No or Low pain" trajectory): having a tetraplegia (odds ratio (OR) = 3.2; P = 0.002) and having limited shoulder ROM (OR = 2.8; P = 0.007). Shoulder pain in people with SCI follows distinct trajectories. At risk for belonging to the "High pain" trajectory are persons with tetraplegia and those with a limited shoulder ROM at start of active rehabilitation.

The level of injury is linked with biochemical alterations and limitations in physical activity among individuals with spinal cord injury (SCI), which are crucial determinants of body composition. We searched five electronic databases from inception until 22 July 2021. The pooled effect estimates were computed using random-effects models, and heterogeneity was calculated using I² statistics and the chi-squared test. Study quality was assessed using the Newcastle–Ottawa Scale. We pooled 40 studies comprising 4872 individuals with SCI (3991 males, 825 females, and 56 sex-unknown) in addition to chronic SCI (median injury duration 12.3 y, IQR 8.03–14.8). Individuals with tetraplegia had a higher fat percentage (weighted mean difference (WMD) 1.9%, 95% CI 0.6, 3.1) and lower lean mass (WMD −3.0 kg, 95% CI −5.9, −0.2) compared to those with paraplegia. Those with tetraplegia also had higher indicators of central adiposity (WMD, visceral adipose tissue area 0.24 dm² 95% CI 0.05, 0.43 and volume 1.05 L 95% CI 0.14, 1.95), whereas body mass index was lower in individuals with tetraplegia than paraplegia (WMD −0.9 kg/mg², 95% CI −1.4, −0.5). Sex, age, and injury characteristics were observed to be sources of heterogeneity. Thus, individuals with tetraplegia have higher fat composition compared to paraplegia. Anthropometric measures, such as body mass index, may be inaccurate in describing adiposity in SCI individuals.

To describe the number, specifics and co-occurrence of shoulder pathologies detected by MRI in manual wheelchair users with spinal cord injury and to evaluate the association between shoulder patho...

The purpose of this article was to describe and to apply a comprehensive set of guiding principles in the selection of measurement instruments for a longitudinal epidemiologic study focusing on functioning using the International Classification of Functioning, Disability, and Health (ICF) as reference framework. Based on the literature, the ICF linkage rules, and the definition of ICF categories to be measured, the following guiding principles for selecting measurement instruments are defined: redundancy, efficiency, level of detail of information, comparability, feasibility, and truth and discrimination. Examples illustrate that the application of guiding principles allows for a systematic and reasoned process of measurement instrument selection and thus offers a potential solution for the multifaceted challenges that one encounters in the selection of measurement instruments. It is transparently demonstrated how the ICF linkage rules enable researchers to address issues such as efficiency, comparability, and redundancy and how the definition of a set of ICF categories to be measured allows assessing inefficiencies in measurement instruments. Because of the ICF linkage rules and the definition of ICF categories to be measured, new guiding principles for selecting measurement instruments emerge. The main challenges lie in the difficulty to quantify and prioritize the applicability of guiding principles and the fact that they strongly interact. Notably, the prioritization and application of guiding principles must be defined considering the specific characteristics and aims of the specific study.