Prevalence of lateral epicondylosis in veteran manual wheelchair users participating in adaptive sports

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1771243 · Published: March 1, 2022

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

This study investigates the prevalence of lateral epicondylosis (LE), or tennis elbow, in manual wheelchair users, a population that relies heavily on their upper bodies. LE is a degenerative condition related to repetitive arm motions. The research compares the occurrence of LE, diagnosed via ultrasound and physical exams, in wheelchair users versus the general population. It also explores if participation in adaptive sports increases the risk of LE. The study found a higher prevalence of LE and related conditions in wheelchair users compared to able-bodied individuals. Age and years of wheelchair use were linked to these conditions, but adaptive sports participation was not.

Study Duration

2018 and 2019

Participants

87 manual wheelchair users

Evidence Level

Prospective, cross-sectional

Key Findings

1
The prevalence of lateral epicondylosis (LE) among manual wheelchair users, determined by physical exam, was 17%.
2
Ultrasound abnormalities indicative of LE were found in 46% of manual wheelchair users.
3
Increased age and years of wheelchair use were significant predictors of ultrasound findings suggestive of LE.

Research Summary

This study aimed to determine the prevalence of lateral epicondylosis (LE) in manual wheelchair users compared to the able-bodied population, and to assess the association between LE and adaptive sport participation. The study found a significantly higher prevalence of both clinically diagnosed LE and ultrasound-detected common extensor tendinopathy (CET) in manual wheelchair users compared to able-bodied individuals. Age and years of wheelchair use were associated with an increased risk of CET, but no association was found between adaptive sport participation and LE.

Practical Implications

Increased awareness

Clinicians should be highly suspicious of LE in manual wheelchair users presenting with elbow pain.

Early Intervention

Early intervention and injury prevention strategies are warranted in this population.

Wheelchair Biomechanics

Attention to proper wheelchair transfer and propulsion techniques is important for managing and preventing upper extremity injuries.

Study Limitations

1
Intrarater and interrater reliability of ultrasound diagnosis of LE were not assessed.
2
Recruitment limited to National Veteran Wheelchair Games may have introduced selection bias.
3
Recall bias due to self-reporting on questionnaires.

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