Risk factors for shoulder pain in patients with spinal cord injury: a multicenter study.

INTRODUCTION: Shoulder pain in spinal cord injury (SCI) is common due to the repetition of the wheelchair propulsion and the increased intra-articular pressure during transfers. Known risk factors for the onset of shoulder pain are age and level of SCI. Aims of this study were to assess how body mass index affects the onset of shoulder pain and to evaluate the relationship between the age at the moment of SCI and the number of years between SCI and the onset of shoulder pain. METHODS: A retrospective study was performed including subjects with SCI between C5 and S3. Excluding criteria were spina bifida and subjects not using manual wheelchair or presenting with shoulder pain before SCI. Patients in the two spinal cord units were reviewed with a self-made questionnaire, and patients were also enrolled during sport events. Age at the moment of SCI, current age and number of years between SCI and the onset of shoulder pain were recorded. RESULTS: Ninety-six patients were enrolled: 77 men and 19 women; 46.4 % reported shoulder pain. Overweight patients who do more than 12 transfers per day showed an increased incidence of shoulder pain (p = 0.0434). A linear regression showed a significant relationship between the age of the subject at the moment of SCI and the number of years between the SCI and the onset of pain. CONCLUSION: Our study confirms that age and level of SCI are risk factors for shoulder pain, but we demonstrated also that overweight patients who do more than 12 transfers per day have higher chances of having shoulder pain.

A new magnetic device for quadriplegia.

STUDY DESIGN: Case report. OBJECTIVES: The objective of this study was to evaluate whether a new custom-made magnetic device might enable a patient affected with quadriplegia to self-feed. SETTING: Day Hospital of the Unipolar Spinal Unit, CTO Hospital, Turin, Italy. METHODS: Three magnets were affixed to a custom-made device and to a specially modified cutlery and a bottle of water. RESULTS: The magnetic device permitted the patient to feed himself autonomously, using both a knife and a fork to eat and a bottle of water to drink. CONCLUSION: Such a magnetic device might be useful for self-feeding in a patient with quadriplegia.

The rehabilitation of severely burned patients: prevention and treatment of scarring.

A detailed description, based on direct personal experience with burn patients, is provided of techniques for the prevention of scar contractures in various parts of the body.

[Standard parameters in gait analysis in an Italian multicenter case study]. / Parametri normativi dell'analisi del cammino in una casistica multicentrica italiana.

The study reports the results of a group who, in a multicentric trial, using a gait analysis laboratory Italian made, and a standard procedure, examined 127 normal subjects. The gait laboratory is composed of contacts to relieve the support on the ground, goniometric transducers with an articulated parallelogram, active sensors for cutaneous electromyography, patient unit for data collection and transmission, interface modules for signal reconstruction, software for data elaboration. All data was elaborated in order to give normative data for Italian population. There were no differences between right and left side, nor between male and female subjects. Values of the present study was compared with previous foreign literature and a critical comment is proposed.

Age related changes in surface myoelectric signals.

The initial values and the time course of muscle fiber conduction velocity and of surface myoelectric signal spectral variables were studied during voluntary or electrically elicited contractions of the tibialis anterior muscle of 15 healthy elderly human subjects. Age ranged from 65 to 84 years. Isometric voluntary contractions were performed at 20% MVC (Maximal Voluntary Contraction) and 80% MVC for 20 s. Tetanic electrical stimulation was then applied to the main muscle motor point for 20 s with surface electrodes. Two stimulation rates (20 Hz and 40 Hz) and two stimulation amplitudes were used to induce different degrees of fatigue. One stimulation amplitude was supramaximal, the second was adjusted to induce a response (M-wave) about 30% of the maximal. Results were compared with those reported in previous work on healthy adults (age range 18 to 43 years). The main findings of this work are: (a) when voluntary contraction level is increased from 20% MVC to 80% MVC conduction velocity and spectral variables increase; this increase is significantly smaller in elderly subjects, (b) during sustained contractions at 80% MVC the decrease of conduction velocity and spectral variables is significantly smaller in elderly subjects, (c) during contractions induced by supramaximal stimulation at 40 Hz the decrease of conduction velocity and spectral variables is not significantly different in the two age groups. It is concluded that points a and b reflect the age related decrease of number and size of fast twitch fibers indicated by histological data. Point c is discussed and possible explanations are suggested.