Abstract
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
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Acknowledgements
We are grateful to the Hospital Nacional de Parapléjicos (Toledo), Centro de Referencia Estatal para la Atención a Personas con Grave Discapacidad y para la Promoción de la Autonomía Personal y Atención a la Dependencia (San Andrés del Rabanedo, León), and the Centro de Recuperación de Personas con Discapacidad Física (CRMF), from Salamanca and Madrid, for their operational help in recruiting the sample. We are also grateful to the Spanish Back Pain Research Network (SBPRN), a not for profit, Spanish private organization specializing in medical research on neck and back pain, with no links to the health industry, for having funded this study.We are grateful to the Hospital Nacional de Parapléjicos (Toledo), Centro de Referencia Estatal para la Atención a Personas con Grave Discapacidad y para la Promoción de la Autonomía Personal y Atención a la Dependencia (San Andrés del Rabanedo, León), and the Centro de Recuperación de Personas con Discapacidad Física (CRMF), from Salamanca and Madrid, for their operational help in recruiting the sample. We are also grateful to the Spanish Back Pain Research Network (SBPRN), a not for profit, Spanish private organization specializing in medical research on neck and back pain, with no links to the health industry, for having funded this study.
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The funding institution had no role in the design and conduction of the study; data collection; management, analysis and interpretation of the data; preparation, review and approval of the manuscript; or the decision to submit the article for publication.
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Kovacs, F. ., Seco, J., Royuela, A. et al. Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: a cross-sectional study. Spinal Cord 56, 392–405 (2018). https://doi.org/10.1038/s41393-017-0029-z
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DOI: https://doi.org/10.1038/s41393-017-0029-z
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