Rotator Cuff Tear Progression at 2-year Follow-up in Manual Wheelchair Users with Spinal Cord Injury

Research Objectives: To investigate rotator cuff tear progression in manual wheelchair (MWC) users with spinal cord injury (SCI) and matched able-bodied individuals.

Design: Longitudinal cohort study, 2-year follow-up.

Setting: Outpatient clinic at a tertiary medical center.

Participants: Thirty-three adult MWC users with SCI (26 men) with an average age (SD) of 42 (12) years and 33 age/sex-matched able-bodied individuals participated in this study. Median time since injury (interquartile ratio) for the SCI participants was 7 (19) years.

Interventions: Not applicable

Main Outcome Measures: Magnetic resonance imaging (MRI) abnormalities of rotator cuff tendons (dominant side) including partial tears (low, intermediate, and high grade) and full tears at baseline and 2-year follow-up visits were graded by a board-certified musculoskeletal radiologist. Presence of shoulder pain was collected.

Results: Fifty-two percent of the MWC users reported shoulder pain at baseline which was significantly higher than able-bodied cohort (10%, P=0.004). The prevalence of any tendon tears across the rotator cuff in MWC users was 61% and 67% at baseline and year 2 visits, respectively, and for able-bodied participants was 45%, and 52%. The MWC users experienced a significant (P=0.001) rotator cuff tear progression from baseline to year 2 (15 participants with worsening score and 2 with improving score). MRI findings did not change significantly for the able-bodied cohort. The MWC user cohort had 3 times (relative risk; 95% CI: 1.23 to 7.30, P = 0.007) higher risk of experiencing rotator cuff tear progression over 2 years in comparison to the able-bodied cohort.

Conclusions: The findings of this study indicate the significantly accelerated rate of rotator cuff degeneration in MWC users with SCI in comparison to able-bodied individuals.

Author(s) Disclosures: National Institutes of Health Funding (grant no. R01 HD84423)