Study aims to uncover sex-specific causes of shoulder pain in wheelchair users

Josh Leonardis received funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health to study why female manual wheelchair users experience shoulder pain and pathology at greater rates than males.

Leonardis is a researcher at the Beckman Institute for Advanced Science and Technology, an assistant professor of health and kinesiology at the University of Illinois Urbana-Champaign and the director of the Musculoskeletal Morphology and Biomechanics Laboratory.

It's well-documented in literature that females experience musculoskeletal pain at greater rates and intensities than their male counterparts, and this rings true for manual wheelchair users. We're seeing females in this cohort experiencing pain, and potentially injuries and pathologies more frequently."

Josh Leonardis, researcher, Beckman Institute for Advanced Science and Technology

Leonardis aims to reveal the sex-specific effects of wheelchair use in childhood and adolescence. He'll measure upper extremity anatomy, physiology, neuromuscular control and biomechanics with the long-term goal to optimize early detection, prevention and treatment of shoulder pain.

While Leonardis and his team will investigate these factors over the next two years, potential solutions include improving the fit of the wheelchair, ideating optimal chair design for individuals and updating usage guidelines which haven't been amended since 2002.

"If a wheelchair user experiences pain, that severely impacts the quality of their life and economic well-being," Leonardis said. "There's a critical need to understand what causes pain and pathology and why females might face these factors more often than males to determine potential treatment options. This grant represents the first step in answering these questions."

The research is novel, as are the techniques that make it possible. Leonardis will use state-of-the-art 3 Tesla MRI scanners in Beckman's Biomedical Imaging Center alongside quantitative morphometrics to quantify the adaptation of upper extremities, allowing the researchers to understand the anatomical changes individuals undergo due to wheelchair use and how these changes relate to pain.

Previously, Leonardis conducted research on how surgery for breast cancer impacted upper extremity musculoskeletal and neuromuscular function after muscles were used to reconstruct breast tissue.

"The best way to make an impact is to be proactive," he said. "We're not looking to simply react to users' pain, but we're aiming to understand what causes the pain so we can develop potential treatment options and prevention protocols."

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