Tsunoda Kenji, Mutsuzaki Hirotaka, Kanae Kyoko, Tachibana Kaori, Shimizu Yukiyo, Wadano Yasuyoshi
Faculty of Social Welfare, Yamaguchi Prefectural University, 6-2-1 Sakurabatake, Yamaguchi, Yamaguchi, 753-0021, Japan.
Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami Ami-machi, Inashiki-gun, Ibaraki, 300-0394, Japan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2021 Feb 16;24:29-34. doi: 10.1016/j.asmart.2021.01.003. eCollection 2021 Apr.
Among injuries in wheelchair athletes, shoulder injury is the most common. An easy and valid assessment tool is required to monitor the shoulder status in wheelchair athletes anytime. The present study aimed to investigate the association of wheelchair user's shoulder pain index (WUSPI) with physical examinations for tendinitis in the long head of the biceps tendon (LHBT) and range of motion (ROM) of shoulder movements among female wheelchair basketball players from the Japanese national team.
A total of 21 female players (mean age, 32.0 ± 7.9 years) participated in this study. LHBT tendinitis was assessed using findings of tenderness in the bicipital groove point (TBGP) and speed test. Shoulder ROMs were evaluated in three movements-namely, abduction, flexion, and extension.
The mean total WUSPI score was 9.55 ± 13.35 points. The players were more likely to experience shoulder pain during activities related to wheelchair pushing and object lifting. A higher total WUSPI score was strongly and moderately associated with positive findings of TBGP (effect size = 0.82) and speed test ( = 0.49), respectively. Furthermore, the total WUSPI score was significantly associated with limited ROM in shoulder abduction ( = 0.47) and flexion ( = 0.43). Receiver operating characteristic analysis showed that the total WUSPI score had a significant area under the curve (AUC) for positive findings of TBGP (AUC = 0.98), speed test (AUC = 0.83), and limited ROM in abduction (AUC = 0.84). When optimal cut-points were set by the Youden index, total WUSPI scores of 4.1 points (sensitivity = 1.00, specificity = 0.92), 11.3 points (sensitivity = 0.80, specificity = 0.81), and 3.3 points (sensitivity = 1.00, specificity = 0.65) were recommended for screening positive findings of TBGP, speed test, and limited ROM in abduction, respectively.
TBGP, which is a major finding of LHBT tendinitis, was strongly associated with the total WUSPI score in physical examinations. Hence, pain assessed by WUSPI could reflect the presence of LHBT tendinitis. The WUSPI is a superior tool for monitoring the shoulder status of wheelchair basketball players.
在轮椅运动员的损伤中，肩部损伤最为常见。需要一种简便有效的评估工具，以便随时监测轮椅运动员的肩部状况。本研究旨在调查日本国家队女子轮椅篮球运动员的轮椅使用者肩部疼痛指数（WUSPI）与肱二头肌长头肌腱（LHBT）肌腱炎的体格检查及肩部运动活动范围（ROM）之间的关联。
共有21名女性运动员（平均年龄32.0±7.9岁）参与本研究。使用肱二头肌沟点压痛（TBGP）和速度试验的结果评估LHBT肌腱炎。通过外展、屈曲和伸展三种运动评估肩部ROM。
WUSPI总评分的平均值为9.55±13.35分。运动员在与推轮椅和举物相关的活动中更容易出现肩部疼痛。较高的WUSPI总评分分别与TBGP阳性结果（效应量=0.82）和速度试验阳性结果（效应量=0.49）呈强相关性和中等相关性。此外，WUSPI总评分与肩部外展（效应量=0.47）和屈曲（效应量=0.43）的ROM受限显著相关。受试者工作特征分析表明，WUSPI总评分对于TBGP阳性结果（曲线下面积[AUC]=0.98）、速度试验阳性结果（AUC=0.83）以及外展ROM受限（AUC=0.84）具有显著的曲线下面积。当通过约登指数设定最佳切点时，推荐WUSPI总评分4.1分（灵敏度=1.00，特异度=0.92）、11.3分（灵敏度=0.80，特异度=0.81）和3.3分（灵敏度=1.00，特异度=0.65）分别用于筛查TBGP阳性结果、速度试验阳性结果和外展ROM受限。
TBGP作为LHBT肌腱炎的主要表现，在体格检查中与WUSPI总评分密切相关。因此，WUSPI评估的疼痛可反映LHBT肌腱炎的存在。WUSPI是监测轮椅篮球运动员肩部状况的优质工具。
