Shoulder pain, functional capacity and quality of life in professional wheelchair basketball players and non-athlete wheelchair users


Ustunkaya, O.; Edeer, A.O.; Donat, H.; Yubatiran, N.

Pain Clinic 19(2): 71-76

2007


Background and Objective: Wheelchair users are exposed to many stresses on their upper extremities. The appearance of shoulder pain related to these stresses could affect their functional capacity and quality of life. The aim of this study was to investigate the shoulder pain and compare the shoulder pain, functional capacity and quality of life between wheelchair basketball players and non-athlete wheelchair users.Methods: Twenty-five wheelchair basketball players (athletes) from professional leagues and 23 non-athlete wheelchair users were included in this study. The subjects' shoulder pain was assessed with the Wheelchair User's Shoulder Pain Index. Timed Forward Wheeling, Forward Vertical Reach and 1-Stroke Push tests were used to measure functional capacity, and the Satisfaction with Life Scale was used to evaluate their quality of life.Results: No differences were found in Wheelchair User's Shoulder Pain Index and Satisfaction with Life Scale score between the athletes and non-athletes (P > 0.05). The scores of functional capacity, height in forward vertical reach test, 1-stroke push distance, and timed forward wheeling were better in the athlete versus the non-athlete group (P < 0.05).Conclusions: Although significantly higher functional capacity is seen in athlete versus non-athlete wheelchair users, their shoulder pain and quality of life may be similar.

Research
article
Shoulder
pain,
functional
capacity
and
quality
of
life
in
professional
wheelchair
basketball
players
and
non-athlete
wheelchair
users
Ozlem
Ustunkaya,
Ayse
Ozcan
Edeer,
Hulya
Donat,
Nuray
Yozbatiran
School
of
Physical
Therapy
and
Rehabilitation,
Dokuz
Eylul
University,
Balcova,
Izmir,
Turkey
Background
and
Objective:
Wheelchair
users
are
exposed
to
many
stresses
on
their
upper
extremities.
The
appearance
of
shoulder
pain
related
to
these
stresses
could
affect
their
functional
capacity
and
quality
of
life.
The
aim
of
this
study
was
to
investigate
the
shoulder
pain
and
compare
the
shoulder
pain,
functional
capacity
and
quality
of
life
between
wheelchair
basketball
players
and
non-athlete
wheelchair
users.
Methods:
Twenty-five
wheelchair
basketball
players
(athletes)
from
professional
leagues
and
23
non-
athlete
wheelchair
users
were
included
in
this
study.
The
subjects'
shoulder
pain
was
assessed
with
the
Wheelchair
User's
Shoulder
Pain
Index.
Timed
Forward
Wheeling,
Forward
Vertical
Reach
and
1-
Stroke
Push
tests
were
used
to
measure
functional
capacity,
and
the
Satisfaction
with
Life
Scale
was
used
to
evaluate
their
quality
of
life.
Results:
No
differences
were
found
in
Wheelchair
User's
Shoulder
Pain
Index
and
Satisfaction
with
Life
Scale
score
between
the
athletes
and
non-athletes
(P
>
0.05).
The
scores
of
functional
capacity,
height
in
forward
vertical
reach
test,
1-stroke
push
distance,
and
timed
forward
wheeling
were
better
in
the
athlete
versus
the
non-athlete
group
(P
<
0.05).
Conclusions:
Although
significantly
higher
functional
capacity
is
seen
in
athlete
versus
non-athlete
wheelchair
users,
their
shoulder
pain
and
quality
of
life
may
be
similar.
Keywords:
wheelchair,
basketball,
shoulder
pain,
functional
capacity,
quality
of
life
Introduction
Wheelchair
users
are
exposed
to
many
stresses
on
their
upper
extremities
during
pushing
their
wheelchair,
carrying
weight
and
other
activities
of
daily
living.
Because
of
these
stresses,
soft
tissue
injuries
and
degenerative
joint
diseases
of
the
shoulder
often
occur.'
For
instance,
research
has
shown
that
repetitive
overhead
activities
with
other
contributing
factors
like
abnormal
positioning
of
the
shoulder,
posture,
age,
Correspondence
to:
Ayse
Ozcan
Edeer
PhD,
Associate
Professor,
School
of
Physical
Therapy
and
Rehabilitation,
Dokuz
Eylul
University,
Balcova,
Izmir
35340,
Turkey
E-mail:
ayseozcan1@gmail.com
compression
and
ischaemia
can
cause
rotator
cuff
irritations in
wheelchair
users.
2
'
3
After
these
injuries
and
traumas,
chronic
pain
usually
appears
in
the
upper
extremities
of
wheelchair
users,
causing
some
difficulties
in
daily
activities
like
pushing,
driving,
dressing
and
transferring.
3-6
The
functional
levels
of
wheelchair
users
could
be
much
lower
when
compared
to
those
of
other
handicapped
people.
Both
low
functional
level
and
upper
extremity
pain
causing
difficulties
in
activities
of
daily
living
negatively
affect
wheelchair
users'
quality
of
life.
In
addition,
sedentary
wheelchair
users
with
low
functional
capacity
tend
to
experience
more
upper
extremity
pain
due
to
weak
muscles.
Wheelchair
users
can
also
participate
in
different
sports
activities,
such
as
athletics,
basketball,
2007
WS.
Maney
&
Son
Ltd
DOI
so.1179/ol6enie7X268657
The
Pain
Clinic
2007
Vol
19
No
2
71
Ustunkaya
et
al.
Shoulder
pain,
functional
capacity
and
QoL
in
professional
wheelchair
basketball
players
and
non-athlete
wheelchair
users
swimming,
tennis,
marksmanship,
rugby,
sailing
and
winter
sports.
7-9
These
kinds
of
sports
increase
motivation,
functional
capacity
and
improve
quality
of
life.
However,
besides
the
injuries
related
to
wheelchair
usage
in
daily
activities
as
mentioned
above,
athlete
wheelchair
users
can
also
be
affected
from
some
injuries
and
over-use
traumas
related
to
the
sports
activities.
1,10
This
is
especially
true
in
basketball,
which
includes
shooting
and
rebound
activities
which
require
repetitive
or
static
shoulder
elevation,
causing
impingement,
rotator
cuff
and
bicipital
degeneration.
11-13
Some
activities
of
daily
living,
including
using
their
wheelchair
and
sleeping,
become
painful
for
basketball
wheelchair
players.
14
Curtis
and
colleagues
15
studied
19
wheelchair
basketball
players
with
spinal
cord
injury
(SCI)
and
19
non-athlete
wheelchair
users.
They
reported
less
medical
attention
and
decreased
hospital
stay,
an
increase
in
functional
skills,
and
indicated
that
sports
activity
is
protective
against
sedentary
risk
factors
like
obesity
and
cardiovascular
diseases
in
wheelchair
basketball
players.
15
While
better
functional
capacity
is
a
contributing
factor
in
decreasing
shoulder
pain,
shoulder
pain
related
to
sports
activities
can
decrease
the
quality
of
life.
Defining
the
shoulder
pain,
the
functional
capacity
and
the
quality
of
life
in
the
population
of
wheelchair
basketball
players
should
give
some
important
information
that
can
be
used
to
offer
sports
activities
to
wheelchair
users.
However,
there
are
few
studies
about
differences
in
pain,
functional
activity
and
quality
of
life
between
wheelchair
basketball
players
and
non-athlete
wheelchair
users.
As
a
result,
we
aimed
to
investigate
shoulder
pain
and
compare
the
shoulder
pain,
functional
capacity
and
quality
of
life
in
wheelchair
basketball
players
and
non-athlete
wheelchair
users.
Materials
and
Methods
Subjects
The
study
was
carried
out
on
48
male
subjects
(25
wheelchair
basketball
players
and
23
non-athlete
wheelchair
users)
between
January
and
September
2005
in
Izmir.
The
inclusion
criteria
were
being
at
least
18
years
old
and
handicapped
for
at
least
the
last
year,
having
no
mental
disorders,
having
the
ability
of
to
read
and
write,
and
use
of
a
wheelchair
in
more
than
50%
of
daily
activities.
Twenty-five
wheelchair
basketball
players
(mean
age,
28.96
±
4.70
years)
who
were
members
of
four
professional
sports
clubs
(Izmir
Municipality
Sports
Club,
Rehabilitation
Sports
Club,
Karsiyaka
The
Handicapped
Sports
Club,
Baris
Gucu
Sports
Club)
were
included
in
the
study.
Eighteen
of
43
professional
wheelchair
basketball
players
were
excluded
from
the
study
because
of
using
their
wheelchair
in
less
than
50%
of
their
daily
activities.
Twenty-three
non-athlete
wheelchair
users
(mean
age,
35.00
±
11.37
years)
who
were
members
or
non-
members
of
several
associations
for
the
handicapped
were
evaluated.
Addresses
and
phone
numbers
of
132
handicapped
individuals
were
obtained
from
Izmir
Governorship
Center
of
the
Handicapped
and
associations
for
the
handicapped;
94
of
them
were
contacted.
Among
the
94
handicapped
individuals,
there
were
18
who
had
a
mental
disability,
29
who
were
under
18
years
of
age,
one
who
was
not
co-operative,
15
who
were
using
their
wheelchair
in
less
than
50%
of
their
daily
activities,
five
who
had
100%
disability,
one
who
did
not
volunteer,
and
two
who
were
blind
that
were
excluded
from
the
study.
A
detailed
medical
history
revealed
the
following
information:
shoulder
pain
before
and
after
becoming
a
wheelchair
user
was
found
to
be
similar
in
both
groups
(athletes
and
non-athletes
before
12%
and
9%
and
after
60%
and
70%,
respectively).
Only
one
subject
in
the
athlete
group
has
had
shoulder
surgery.
Of
the
athletes,
44%
reported
current
shoulder
pain,
whereas
only
17%
of
the
non-athletes
had
current
shoulder
pain.
Professional
medical
attention
was
sought
in
72%
of
the
athlete
group
versus 65%
in
the
non-athlete
group.
Restriction
of
daily
activities
due
to
shoulder
pain
within
the
last
week
occurred
in
6
subjects
(24%)
in
the
athlete
group,
whereas
many
fewer
subjects
(2
subjects;
9%)
in
the
non-athlete
group
reported
restriction.
When
the
subjects
were
further
interviewed
for
the
existence
of
pain
at
the
elbow
or
hand
after
becoming
a
wheelchair
user,
almost
all
of
the
subjects
(92%)
in
the
athlete
group
reported
pain
in
the
elbow
or
hand,
and
only
half
of
the
subjects
(52%)
in
the
non-athlete
group.
The
Ethics
Committee
of
Dokuz
Eylul
University
approved
this
study.
Information
about
this
study
was
given
to
the
subjects.
Procedure
After
recording
the
demographic
and
medical
information,
shoulder
pain,
functional
capacity
and
quality
of
life
were
evaluated.
A
questionnaire
was
used
to
note
demographics
and
medical
history.
16,17
Demographics
included
age,
gender,
body
mass
index
(BMI),
marital
status,
duration
of
wheelchair
usage,
type
of
handicaps,
frequency
of
wheelchair
transfers
per
day,
and
hours
per
week
spent
at
work
and/or
school,
in
sporting/recreational
activities
and
driving.
72
The
Pain
Clinic
2007
Vol
19
No
2
Ustunkaya
et
al.
Shoulder
pain,
functional
capacity
and
QoL
in
professional
wheelchair
basketball
players
and
non-athlete
wheelchair
users
In
the
medical
history,
the
following
items
were
noted:
the
shoulder
pain
felt
before
using
the
wheelchair,
the
shoulder
pain
felt
during
the
wheelchair
usage,
the
shoulder
pain
felt
at
the
present
time,
whether
or
not
an
individual
was
getting
medical
help
to
avoid
the
shoulder
pain,
the
activities
done
to
avoid
the
shoulder
pain,
whether
or
not
the
shoulder
pain
restricted
daily
activities
in
the
last
week,
and
whether
there
was
any
pain
or
wound
either
of
the
hand
or
elbow
because
of
using
a
wheelchair.
The
Wheelchair
User's
Shoulder
Pain
Index
(WUSPI)
was
used
to
assess
the
intensity
of
pain
during
activities
of
daily
living.
The
WUSPI,
which
includes
five
items,
was
described
and
shown
to
be
valid
and
reliable
by
Curtis
et
a1.
16
A
performance-
corrected
WUSPI
(PC-WUSPI)
was
calculated
and
used
for
analysis.
In
order
to
describe
the
functional
capacity,
three
tests,
which
were
improved
by
May
et
al.
18
for
functional
works,
were
used
in
our
study:
(i)
timed
forward
wheeling
(time
to
wheel
as
quickly
as
possible
over
a
23-m
linoleum
surface);
(ii)
forward
vertical
reach
(height
measured
from
the
floor
attained
when
participants
held
a
measuring
stick
in
a
horizontal
position
with
both
hands,
raising
it
forward
and
up
as
far
as
possible);
and
(iii)
one-stroke
push
(distance
completed
with
one
maximal
push
on
a
carpeted
surface).
To
avoid
upper-extremity
fatigue,
participants
were
given
a
rest
between
tests.
Ramp
ascent
activity,
which
is
the
fourth
test
described
by
May
et
al.
18
for
functional
work,
was
not
used
in
this
study
because
it
was
not
practical.
Quality
of
life
was
measured
with
the
Satisfaction
with
Life
Scale
(SWLS).
19
The
SWLS
is
a
well-validated
measure
of
subjective
satisfaction
with
life
that
allows
respondents
to
weigh
domains
of
their
lives
in
terms
of
their
own
values.
The
SWLS
consists
of
five
statements
measured
on
a
7-point
Likert
scale
(ranging
from
1
[completely
disagree]
to
7
[completely
agree]);
the
total
score
can,
therefore,
range
from
5
to
35.
Statistical
analysis
The
Mann-Whitney
U-test
was
used
to
compare
the
demographics,
the
WUSPI
subscores
and
PC-WUSPI
scores,
the
functional
capacity
and
the
satisfaction
with
life
between
the
wheelchair
basketball
players
and
non-athlete
wheelchair
users.
For
all
tests,
significance
was
set
0.05.
SPSS
v.11
(Statistical
Package
for
Social
Sciences)
was
used
for
the
statistical
analyses.
Results
In
total,
48
subjects
were
evaluated
-
25
athlete
wheel-
chair
basketball
players
and
23
non-athlete
wheelchair
users.
There
was
no
statistically
significant
difference
between
the
groups
regarding
age,
number
of
transfers
and
total
time
for
using
the
wheelchair.
The
results
revealed
that
the
BMI
of
the
non-athlete
group
was
significantly
higher
than
that
of
the
athlete
group.
In
addition,
the
time
spent
for
school/work
and
sports
or
recreational
activities
was
found
to
be
significantly
higher
in
the
athlete
versus
the
non-athlete
group
(P
<
0.05;
Table
1).
The
marital
status,
type
of
wheelchair
used,
type
of
disability,
driving
and
employment
status
of
the
groups
are
given
in
Table
2.
There
was
no
difference
between
groups
regarding
the
WUSPI
subscores
(Table
3).
Additionally,
there
was
no
difference
in
PC-WUSPI
and
quality
of
life
between
the
two
groups.
However,
the
height
in
forward
vertical
reach
test
and
1-stroke
push
distance
were
found
to
be
higher
and
the
time
for
the
forward
wheeling
test
was
found
to
be
less
in
the
athlete
versus
the
non-athlete
group
(P
<
0.05;
Table
4).
Discussion
In
our
study,
25
athlete
and
23
non-athlete
wheelchair
users
were
compared
to
determine
differences
in
shoulder
pain,
functional
capacity
and
quality
of
life.
We
found
that
functional
capacity
was
significantly
higher
in
wheelchair
basketball
players
than
non-
athlete
wheelchair
users,
whereas
shoulder
pain
and
quality
of
life
did
not
differ
between
the
groups.
It
was
Table
1
Demographic
information
of
the
athletes
and
non-athletes
Athletes
(n
=
25)
Non-athletes
(n
=
23)
P-value
Age
(years)
28.96
±
4.70
35.00
±
11.37
NS
BMI
(kg/m
2
)
21.10
±
2.32
25.40
±
7.06
<
0.05
Number
of
transfer
(times
per
day)
9.60
±
12.62
6.39
±
4.41
NS
Duration
of
wheelchair
use
(years)
11.18
±
6.07
11.63
±
8.32
NS
Work
and/or
school
(h/week)
34.52
±
25.52
19.71
±
28.99
<
0.05
Sporting/recreational
activities
(h/week)
9.70
±
3.74
8.54
±
10.62
<
0.05
Values
are
mean
±
SD;
P-values
from
Mann
Whitney
U-test;
NS,
not
significant.
The
Pain
Clinic
2007
Vol
19
No
2
73
Ustunkaya
et
al.
Shoulder
pain,
functional
capacity
and
QoL
in
professional
wheelchair
basketball
players
and
non-athlete
wheelchair
users
Table
2
Marital
status,
type
of
wheelchair,
type
of
disability,
driving
and
employment
status
of
the
athletes
and
non-athletes
n
=
25
Athletes
Non-athletes
n
=
23
Marital
status
Single
12
48.0
13
57.0
Married
13
52.0
6
26.0
Divorced
2
9.0
Widowed
2
9.0
Type
of
wheelchair
Manual
25
100
20
87
Manual
and
power
3
13
Type
of
disability
SCI
2
8.0
11
47.8
Polio
18
72.0
1
4.3
Amputation
3
12.0
5
21.7
Spina
bifida
0
0
2
8.7
Other
2
8.0
4
17.4
Driving
Yes
7
28.0
7
30.0
No
18
72.0
16
70.0
Employment
status
Official
13
52
6
26
Student
2
8
5
22
Retired
2
8
5
22
Volunteer
1
4
1
4
Other
7
28
6
26
Table
3
The
comparison
of
WUSPI
subscores
of
groups
Athletes
(n
=
25)
Non-athletes
(n
=
23)
P-value
Transferring
from
bed
to
a
wheelchair
1.00
±
2.30
0.88
±
2.23
NS
Transferring
from
a
wheelchair
to
car
0.50
±
1.58
0.85
±
2.08
NS
Transferring
from
a
wheelchair
to
the
tub
or
shower
1.50
±
2.59
0.14
±
0.53
NS
Loading
the
wheelchair
into
a
car
2.25
±
3.07
Not
performed
Pushing
your
chair
for
10
min
or
more
3.04
±
2.98
2.42
±
2.97
NS
Pushing
up
outdoor
ramps
or
inclines
2.58
±
2.68
3.88
±
3.58
NS
Lifting
objects
down
from
an
overhead
shelf
2.08
±
3.21
0.89
±
2.60
NS
Putting
on
pants
0.41
±
1.41
0.26
±
1.14
NS
Putting
on
a
T-shirt
or
pullover
0.62
±
1.46
0.45
±
1.47
NS
Putting
on
a
button-down
shirt
0.45
±
1.28
0.33
±
1.15
NS
Washing
your
back
1.70
±
2.61
4.06
±
13.73
NS
Usual
daily
activities
at
work
or
school
1.12
±
1.67
1.90
±
2.38
NS
Driving
0.60
±
1.34
3.12
±
3.04
NS
Performing
household
chores
0.58
±
1.50
1.25
±
2.31
NS
Sleeping
1.95
±
2.36
2.30
±
3.02
NS
WUSPI,
Wheelchair
User's
Shoulder
Pain
Index.
Values
are
mean
±
SD;
P-values
from
Mann
Whitney
U-test;
NS,
not
significant.
Table
4
The
comparison
of
scores
of
the
PC-WUSPI,
the
SWLS
and
functional
tasks
Athletes
(n
=
25)
Non-athletes
(n
=
23)
P-value
PC-WUSPI
21.59
±
20.71
20.84
±
22.35
NS
SWLS
21.12
±
6.02
21.34
±
6.87
NS
Functional
tasks
Timed
forward
wheeling
(s)
7.23
±
1.19
16.52
±
10.87
<
0.001
Forward
vertical
reach
(cm)
12E07
±
13.75
114.21
±
17.68
<
0.001
1-stroke
push
(cm)
583.69
±
173.89
238.45
±
94.76
<
0.001
PC-WUSPI,
Performance-Corrected
Wheelchair
User's
Shoulder
Pain
Index;
SWLS,
Satisfaction
with
Life
Scale'
Values
are
mean
±
SD;
P-values
from
Mann
Whitney
U-test;
NS,
not
significant.
important
that
there
was
no
statistically
significant
difference
between
the
groups
regarding
age,
number
of
transfers
and
total
years
of
using
the
wheelchair.
However,
amongst
the
demographic
information,
the
distribution
of
some
types
of
disabilities
(e.g.
SCI
and
polio)
showed
differences
between
the
groups,
which
might
have
affected
the
study
results.
As
expected,
because
the
time
spent
for
school/work
and
sports
or
recreational
activities
was
higher
in
athletes,
their
BMI
was
lower
and
functional
capacity
was
better
than
74
The
Pain
Clinic
2007
Vol
19
No
2
Ustunkaya
et
al.
Shoulder
pain,
functional
capacity
and
QoL
in
professional
wheelchair
basketball
players
and
non-athlete
wheelchair
users
those
of
the
non-athlete
group.
The
functional
task
test
that
was
developed
and
proven
reliable
by
May
et
al."
in
2003
was
used
in
our
study.
As
the
functional
tasks
of
groups
were
compared,
it
was
seen
that
athletes
showed
much
better
performances
in
the
forward
vertical
reach,
1-stroke
push
and
timed
forward
wheeling
tests
than
non-athletes.
This
result
suggested
that
basketball
playing
increases
functional
levels
in
wheelchair
users.
Because
the
BMI
of
non-
athletes
was
higher
than
athletes,
it
could
be
thought
of
as
another
reason
why
athletes
showed
better
performance
in
the
functional
tasks.
On
the
other
hand,
it
could
be
thought
that
basketball
playing
decreases
body
mass
index
in
wheelchair
users.
In
the
literature,
there
are
many
studies
reporting
shoulder
pain
in
wheelchair
users.
Curtis
and
colleagues'
reported
shoulder
pain
when
pushing
the
wheelchair
for
10
min
or
more,
sleeping,
and
pushing
up
ramps
in
195
wheelchair
users
with
SCI.
In
another
study,
Curtis
and
colleagues
14
reported
shoulder
pain
in
other
activities,
such
as
household
activities,
pushing
up
ramps,
lifting
objects
down
from
an
overhead
shelf
and
during
sleep
in
46
female
wheelchair
basketball
players.
Gironda
and
colleagues'
noted
shoulder
pain
during
wheelchair
mobility
and
transfer
activities.
Finley
and
colleaguesl°
found
shoulder
pain
during
sleeping,
transfer
activities,
lifting
5
litres,
and
lifting
an
object
down
from
an
overhead
shelf
in
athlete
wheelchair
users.
Similarly,
in
our
study,
athletes
stated
shoulder
pain
during
pushing
the
wheelchair
for
10
min
or
more,
pushing
up
outdoor
ramps
and
inclines,
and
loading
the
wheelchair
into
a
car,
etc.,
whereas
non-athletes
stated
shoulder
pain
during
washing
their
back,
pushing
up
outdoor
ramps
or
inclines,
driving,
etc.
However,
there
was
no
significant
difference
in
any
WUSPI
item
between
the
groups.
Dyson-Hudson
and
colleagues"
found
that
the
PC-
WUSPI
scores
were
48.9
±
24.6
in
18
subjects
with
SCI
suffering
from
shoulder
pain,
while
Curtis
and
Black
14
reported
that
the
PC-WUSPI
score
was
15.6
±
20.5
in
46
female
basketball
players
with
different
disabilities,
including
spinal
cord
injury,
various
musculoskeletal
and
neuromuscular
extremity
disabilities,
post-polio
paralysis,
spina
bifida,
and
amputations.
In
our
study,
the
PC-WUSPI
score
was
21.59
±
20.11
in
the
athlete
group
and
20.84
±
22.35
in
the
non-athlete
group.
The
reason
we
think
our
WUSPI
scores
were
closer
to
those
of
Curtis
and
Black
14
is
that
our
study
also
consisted
of
subjects
with
different
pathologies,
like
poliomyelitis,
amputation,
and
spina
bifida,
in
addition
to
SCI.
In
addition,
another
interesting
finding
in
our
study
was
the
similarity
of
the
PC-WUSPI
scores
between
athletes
and
non-athletes.
Thus,
we
thought
that
the
shoulder
pain
might
not
be
related
to
basketball
playing
but
to
the
use
of
a
wheelchair.
We
suggest
that
basketball
playing
has
no
negative
or
positive
effect
on
the
shoulder
pain.
Another
point
of
view
worth
mentioning
is
that,
although
shoulder
pain
evaluated
with
WUSPI
did
not
differ
between
the
groups
in
our
study,
the
pain
reported
in
the
medical
history
was
not
similar
between
the
groups
in
some
aspects.
In
both
groups,
the
reported
shoulder
pain
seemed
to
increase
after
becoming
a
wheelchair
user.
However,
the
percentage
of
reported
current
shoulder
pain,
medical
attention,
restriction
of
daily
living
activities
and
presence
of
hand/elbow
pain
since
becoming
a
wheelchair
user
seemed
to
be
higher
in
the
athlete
group.
It
is
generally
known
that
sports
activities
have
a
protective
effect
due
to
strengthening
of
the
muscles,
and
can
improve
the
quality
of
life
in
many
ways
when
compared
to
a
sedentary
wheelchair
user.
On
the
other
hand,
it
can
be
thought
that
because
of
the
extra
musculoskeletal
stresses
related
to
sports
activities,
the
same
or
more
pain
appears
in
athlete
wheelchair
users
that,
as
a
result,
can
affect
activities
of
daily
living
and
quality
of
life.
Although
athlete
wheelchair
users
have
significantly
higher
functional
capacity,
which
is
expected
to
increase
the
quality
of
life,
athlete
wheelchair
users'
shoulder
pain
would
be
similar
or
show
a
higher
incidence
than
in
non-athlete
wheelchair
users.
Therefore,
the
quality
of
life
may
not
differ
between
athlete
and
non-athlete
wheelchair
users.
Vogel
and
colleagues
21
reported
SWLS
score
of
22.7
in
46
wheelchair
users
with
SCI
and
Putzke
and
colleagues,
22
who
followed
940
subjects
with
SCI
for
2
years,
found
SWLS
score
of
17.3.
In
our
study,
wheelchair
users'
SWLS
scores
were
similar
to
those
of
previous
studies.
In
addition,
no
significant
difference
in
SWLS
scores
was
found
between
athletes
and
non-
athletes
(21.12
in
athletes,
21.34
in
non-athletes).
In
general,
quality
of
life
is
related
not
only
to
physical
functions
but
also
age,
marital
status,
social
security,
work,
income,
family,
social
integration,
environ-
mental
structure,
type
of
handicap
and
the
reason
for
handicap.
21'22
Conclusions
There
is
no
difference
between
the
PC-WUSPI
and
SWLS
scores
of
athletes
and
non-athletes
using
wheelchairs,
and
athletes
have
better
performance
on
functional
task
tests.
It
is
concluded
that
basketball
The
Pain
Clinic
2007
Vol
19
No
2
75
Ustunkaya
et
al.
Shoulder
pain,
functional
capacity
and
QoL
in
professional
wheelchair
basketball
players
and
non-athlete
wheelchair
users
playing
does
not
affect
the
shoulder
pain
and
quality
of
life
of
wheelchair
users,
but
it
does
improve
functional
capacity.
It
is
thought
that
doing
the
study
on
more
subjects
could
yield
different
results.
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