PURPOSE/HYPOTHESIS: Musculoskeletal pain problems frequently occur in subjects with chronic spinal cord injury (SCI). It is unclear, however, if the subjects activity level plays a role in the development of chronic musculoskeletal pain. This survey research study was designed to evaluate the activity patterns and incidence of pain experienced by subjects greater than 5 years post SCI. Our hypothesis was that subjects with increased activity levels would experience an increased incidence of musculoskeletal pain. NUMBER OF SUBJECTS: Five hundred subjects were randomly selected from the Shepherd Hospitals database (Atlanta, GA). Inclusion criteria: subjects were at least 18 yrs of age and at least 5 years post traumatic SCIA 29 item questionnaire was mailed with a SASE to all participants and 127 surveys were returned. Seven surveys were incomplete and were not further analyzed. Therefore, 120 surveys were utilized for data analyses constituting an approximately 25% response rate. MATERIALS/METHODS: Multiple choice, fill in, and Likert-Scale type questions were developed based on an extensive literature search, as well as, on previous pilot work (Hutchinson et al. Activity Level and Musculoskeletal Pain in Subjects Greater than Five Years Post Spinal Cord Injury. Neurology Report:Dec 2002;26(4): 190-191). Descriptive statistics were run on all questions. A priori comparisons were analyzed using Chi-square analyses for categorical data and PPMCC and t-tests for interval and ratio data sets. SPSS v. 11.01 was utilized. RESULTS: Demographic data: 93 males and 27 females responded representing 57, 47, and 16 subjects with cervical, thoracic and lumbar/sacral injuries, respectively. Ninety percent of the ambulatory patients with SCI complained of lower extremity pain (LE), but only 20-30% of the wheelchair users complained of LE pain (p<.000). However, 67 to 70% of wheelchair users complained of pain involving either one or both upper extremities (UE), whereas, 50% of the ambulatory patients complained of UE pain. This difference was not significant. Analyses of data, collapsed across injury categories, revealed that the mean number of transfers per week was significantly higher for those diagnosed with UE pathological conditions versus those without (p<.001). Also, the mean number of transfers/wk was significantly higher for those who identified shoulder, elbow or wrist pain during transfers (p <.001) versus those who did not have UE pain with transfers. CONCLUSIONS: Incidence of musculoskeletal pain, in subjects with chronic SCI, appears to follow activity patterns. These data suggest that high activity levels may play a role in the development of musculoskeletal pain patterns in subjects with chronic SCI. CLINICAL RELEVANCE: Further research is needed to identify potential thresholds of activity, beyond which participation in an activity would likely lead to long term chronic pain patterns.
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