Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: a cross-sectional study

[EN] Study design: Cross-sectional study. Objectives: To determine the prevalence of, and factors associated with, spinal pain among wheelchair users. Setting: Four Spanish hospitals specialized in providing care for wheelchair users. Methods: Persons who had used a wheelchair for a median (IRQ) of...

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Detalhes bibliográficos
Autores: Kovacs, Francisco M., Seco Calvo, Jesús Ángel, Royuela Vicente, Ana, Barriga Martín, Andrés, Zamora Romero, Javier
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:España
Recursos:Universidad Rey Juan Carlos
Repositorio:BULERIA. Repositorio Institucional de la Universidad de León
OAI Identifier:oai:buleria.unileon.es:10612/19640
Acesso em linha:https://www.nature.com/articles/s41393-017-0029-z
https://hdl.handle.net/10612/19640
Access Level:acceso abierto
Palavra-chave:Medicina. Salud
Neck pain
Wheelchair users
Cross-sectional study
Spinal pain
Spanish hospitals
Descrição
Resumo:[EN] Study design: Cross-sectional study. Objectives: To determine the prevalence of, and factors associated with, spinal pain among wheelchair users. Setting: Four Spanish hospitals specialized in providing care for wheelchair users. Methods: Persons who had used a wheelchair for a median (IRQ) of 10 (5;19) years, 27% of them due to reasons other than spinal cord injury, were recruited consecutively (n = 750). Data on 43 demographic, psychosocial, ergonomic, and clinical variables were collected, and analyzed. Main outcome measures were: Point prevalence of neck (NP), thoracic (TP), low back pain (LBP), and pain at any spinal level (PASL); and factors associated with them. Results: Point prevalence was 56% for NP, 54% for TP, 45% for LBP, and 76% for PSAL. PASL was associated with a lower quality of life (OR (95% CI) 0.91 (0.86; 0.97)). Multivariable regression models showed that the main factors associated with significant pain (≥1.5 VAS points) were: (a) For NP: Cervical spinal injury and wheelchair seat cushion thickness, (b) For TP: Thoracic spinal injury and sagittal index, (c) For LBP: Thoracic or lumbar spinal injury, with some sensitivity remaining, (d) For PASL: Being female, living alone, and using a non-power wheelchair. Discrimination (AUC) of these models ranged between 0.638 and 0.818. p-values in the Hosmer-Lemeshow test ranged between 0.420 and 0.701. Conclusions: Prevalence of spinal pain among wheelchair users is high. It is associated with a lower quality of life. Future studies should assess whether using a power wheelchair affects PASL, and if the thickness of seat cushion affects NP. Sponsorship: Spanish Back Pain Research Network