Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: A cross-sectional study

Francisco M. Kovacs; Jesús Seco; Ana Royuela; Andrés Barriga; Javier Zamora

doi:10.1038/s41393-017-0029-z

Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: A cross-sectional study

Francisco M. Kovacs^*, Jesús Seco, Ana Royuela, Andrés Barriga, Javier Zamora

^*Corresponding author for this work

Metabolism and Systems Research

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

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.

Original language	English
Pages (from-to)	392-405
Number of pages	14
Journal	Spinal Cord
Volume	56
Issue number	4
DOIs	https://doi.org/10.1038/s41393-017-0029-z
Publication status	Published - 1 Apr 2018

Bibliographical note

Funding Information:
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 Autonomiá 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 Autonomiá 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.

Publisher Copyright:
© 2017 International Spinal Cord Society.

ASJC Scopus subject areas

Rehabilitation
Neurology
Clinical Neurology

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title = "Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: A cross-sectional study",

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.",

author = "Kovacs, {Francisco M.} and Jes{\'u}s Seco and Ana Royuela and Andr{\'e}s Barriga and Javier Zamora",

note = "Funding Information: We are grateful to the Hospital Nacional de Parapl{\'e}jicos (Toledo), Centro de Referencia Estatal para la Atenci{\'o}n a Personas con Grave Discapacidad y para la Promoci{\'o}n de la Autonomi{\'a} Personal y Atenci{\'o}n a la Dependencia (San Andr{\'e}s del Rabanedo, Le{\'o}n), and the Centro de Recuperaci{\'o}n de Personas con Discapacidad F{\'i}sica (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 Parapl{\'e}jicos (Toledo), Centro de Referencia Estatal para la Atenci{\'o}n a Personas con Grave Discapacidad y para la Promoci{\'o}n de la Autonomi{\'a} Personal y Atenci{\'o}n a la Dependencia (San Andr{\'e}s del Rabanedo, Le{\'o}n), and the Centro de Recuperaci{\'o}n de Personas con Discapacidad F{\'i}sica (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. Publisher Copyright: {\textcopyright} 2017 International Spinal Cord Society.",

year = "2018",

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doi = "10.1038/s41393-017-0029-z",

language = "English",

volume = "56",

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T1 - Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users

T2 - A cross-sectional study

AU - Kovacs, Francisco M.

AU - Seco, Jesús

AU - Royuela, Ana

AU - Barriga, Andrés

AU - Zamora, Javier

N1 - Funding Information: 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 Autonomiá 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 Autonomiá 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. Publisher Copyright: © 2017 International Spinal Cord Society.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - 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.

AB - 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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Prevalence and factors associated with a higher risk of neck and back pain among permanent wheelchair users: A cross-sectional study

Abstract

Bibliographical note

ASJC Scopus subject areas

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