Development of a Biopsychosocial Prospective Surveillance Model of Shoulder Pain in Individuals with Spinal Cord Injury
This Department of Defense funded SCIRP study (Award W81XWH-17-1-0476) will investigate the progression of musculoskeletal and psychosocial impairments for the first year following SCI, starting with inpatient rehabilitation, at six months and at one year following SCI. Our research will be performed at two facilities: Drexel University (in collaboration with Magee Rehabilitation Hospital) and the University of Maryland Rehabilitation & Orthopaedic Institute.
We will identify sources of biopsychosocial shoulder pain to establish effective physical and cognitive-behavioral treatment to prevent loss of function and independence in individuals with SCI who depend on their arms for activities of daily living, transfers and wheelchair propulsion. Early identification of problem areas may provide a method to refer a patient for treatment or to change ongoing intervention. Development of a biopsychosocial prospective surveillance model will provide a proactive approach to reduce the debilitating consequences of activity limitations and participation restrictions in individuals with SCI, reducing the burden currently experienced by military service members, veterans and their families and caregivers.
Role: Principal Investigator
Factors Associated with Shoulder Pain in Manual Wheelchair Users with Spinal Cord Injury
Early onset of shoulder pain in manual wheelchair users is predictive of persistent long-term shoulder pain. Chronic rotator cuff disease, with resultant subacromial impingement syndrome, and chronic inflammatory conditions are the most common health conditions associated with shoulder pain in this population. Development of rotator cuff disease is multifactorial and includes intrinsic, extrinsic and overuse factors. The aims of this project are: 1) to compare neuromusculoskeletal factors associated with shoulder pain across groups of varied duration of injury and wheelchair use; 2) to identify neuromusculoskeletal factors that are predictive of shoulder pain in manual wheelchair users with SCI, across three different time intervals. Our hypothesis is that specific neuromusculoskeletal impairments will be predictive of shoulder pain at various time points following a spinal cord injury.
Association of Psychosocial Factors to Musculoskeletal Pain in Manual Wheelchair Users
Disability and reduced quality of life (QoL) associated with musculoskeletal shoulder pain in individuals who use a manual wheelchair for mobility and lack of knowledge of biopsychosocial mechanisms of shoulder pain in the acute and chronic phase support the scientific premise for this proposal. In persons with chronic SCI, pain catastrophizing is a strong predictor of QoL and is associated with disability and fear of movement (kinesiophobia). Pain catastrophizing has been identified as one of the most important psychological variables for explaining responses to pain. The aim of this pilot study is to determine the relationship between shoulder pain, psychosocial factors, QoL and duration of manual wheelchair use.
Influence of Resting Pectoralis Minor Muscle Length on Shoulder Girdle Kinematics
The purpose of this study is to determine the influence of resting pectoralis minor muscle length and pectoralis minor muscle extensibility on shoulder girdle motion during overhead reaching tasks. Specifically this study intends to answer the following questions: 1) Does shoulder girdle motion during overhead reaching differ between individuals with typical and short resting pectoralis minor muscle length; 2) Do pectoralis minor muscle length changes during overhead reaching differ between individuals with typical and short resting pectoralis minor muscle length; and 3) Does pectoralis minor muscle extensibility differ between individuals with typical and individuals with a short pectoralis minor muscle resting length?
Complete List of Published Work in MyBibliography
Finley M.A., Ebaugh, D., Trojian, T. Agreement of musculoskeletal ultrasound and clinical assessment of shoulder impairment in manual wheelchair users with various duration of spinal cord injury. Archives of Physical Medicine and Rehabilitation (ePub ahead of print) DOI: 10.1016/j.apmr.2017.12.015 https://www.ncbi.nlm.nih.gov/pubmed/29339205
Ebaugh, D.,Finley, M., Goodstadt, N. Resting pectoralis minor muscle length, an accurate way to determine if the muscle is shortened? (2017) Journal Hand Therapy, 30(4):e9.
Jones, E., McPoil, T, Fruth, S. Finley, MA. Comparison of Graston technique instrument-assisted soft tissue mobilization and stretching for the management of chronic plantar heel pain – A Pilot Study. (2017) Journal of the American Podiatric Medical Association. (in press)
Wright, H. O’Brien, V., Valdes, K., Koczan, B., MacDermid, J., Moore, E., Finley, MA. Relationship of the patient specific functional scale to commonly used clinical measures in hand osteoarthritis. (2017) Journal Hand Therapy, 30(4):538-545.
Finley, MA & Ebaugh, DD. Association of pectoralis minor extensibility, shoulder mobility and duration of manual wheelchair use. (2017) Archives Physical Medicine and Rehabilitation, 98(10), 2028-2033.
Finley, MA, Goodstadt, N., Soler, D., Somerville, K., Friedman, Z., Ebaugh, D. Reliability and validity of a novel technique for active and passive pectoralis minor muscle length measures. (2017) Brazilian Journal of Physical Therapy, 21(3), 212-218. http://www.sciencedirect.com/science/article/pii/S1413355517300667
Finley, M., Jelinek, JA., & Misamore, G. (2015). Three-dimensional analysis versus goniometric measurement of total active elevation in normal subjects. Journal Shoulder and Elbow Surgery, 24(9), 1391-1396.
Rundquist, PJ., Dumit, M., Hartley, J., Schultz, K., & Finley, MA. (2012). Three-dimensional shoulder complex kinematics in individuals with upper extremity impairment from chronic stroke. Disability and Rehabilitation, 34(5), 402-407.
Finley, MA., & Rodgers, MM. (2007). Effect of 2-speed geared manual wheelchair propulsion on shoulder pain and function. Archives of Physical Medicine and Rehabilitation, 88(12), 1622-1627.
Finley, MA., McQuade, KJ., & Rodgers, M M. (2005). Scapular kinematics during transfers in manual wheelchair users with and without shoulder impingement. Clinical Biomechanics (Bristol, Avon), 20(1), 32-40.
Finley, MA., Fasoli, SE., Dipietro, L., Ohlhoff, J., Macclellan, L., Meister, C., . . . Hogan, N. (2005). Short-duration robotic therapy in stroke patients with severe upper-limb motor impairment. Journal of Rehabilitation Research & Development, 42(5), 683-692.
Finley, MA., & Rodgers, MM. (2004). Prevalence and identification of shoulder pathology in athletic and nonathletic wheelchair users with shoulder pain: A pilot study. Journal of Rehabilitation Research & Development, 41(3B), 395-402.
Finley, MA., & Lee, RY. (2003). Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors. Archives of Physical Medicine & Rehabilitation, 84(4), 563-568. doi:10.1053/apmr.2003.50087.