Context/Objective: Wheelchair users with spinal cord injury (SCI) have a high risk of developing shoulder pain, caused by rotator cuff disease. Platelet-rich plasma (PRP) is a potential treatment after conservative treatments fail and prior to surgical intervention; however, it has not been tested in wheelchair users who have recalcitrant shoulder pain associated with rotator cuff disease. The objective of this pilot project was to test the safety and potential treatment effect of an ultrasound-guided PRP injection for shoulder pain in the aforementioned population.

Design: Prospective, quasi-experimental.

Setting: Clinical research center.

Participants: Six wheelchair users with SCI (3 paraplegia, 3 tetraplegia) who had chronic shoulder pain due to rotator cuff disease (presence of anterior shoulder pain, positive physical examination tests for rotator cuff disease, and tendinopathy demonstrated by ultrasound) and failed at least six months of conservative treatment.

Interventions: Ultrasound-guided PRP injection into pathological shoulder tendons, targeting the supraspinatus. Subjects were provided a standardized stretching and strengthening program and were followed for 4, 8, 12, and 24 weeks post-intervention with outcomes collected at each time-point.

Outcome Measures: Wheelchair User's Shoulder Pain Index (WUSPI); pain Numerical Rating Scale (NRS); physical and ultrasound examinations for supraspinatus tendinopathy; 5-point patient global impression of change (PGIC).

Results: WUSPI (69.9%, P < 0.001), NRS (49.6%, P < 0.01), and physical exam scores (35.7%, P < 0.01) decreased 24 weeks after treatment. Participants reported overall improvement in their status as a result of the treatment. No adverse events were noted, and no changes in ultrasound markers for tendinopathy were observed.

Conclusion: A single, ultrasound-guided PRP injection into the supraspinatus tendon, followed by a stretching and strengthening exercise program, was safe and provided improvements in shoulder pain outcome measures in this sample for 24 weeks. Lack of blinding, short-term follow-up, and a suitable control group warrant a larger randomized controlled trial.

Trial Registration: NCT01355549

背景/目标：患有脊髓损伤 (SCI) 的轮椅使用者发生肩痛的风险很高，这是由肩袖疾病引起的。富血小板血浆 (PRP) 是保守治疗失败后和手术干预前的潜在治疗方法；然而，它尚未在患有与肩袖疾病相关的顽固性肩痛的轮椅使用者中进行测试。该试点项目的目的是测试超声引导 PRP 注射对上述人群肩痛的安全性和潜在治疗效果。

设计：前瞻性，准实验性。

地点：临床研究中心。

参与者： 6 名患有 SCI 的轮椅使用者（3 名截瘫，3 名四肢瘫痪），他们因肩袖疾病而患有慢性肩痛（存在肩前部疼痛、肩袖疾病的体格检查阳性和超声显示的肌腱病）并且至少失败六个月的保守治疗。

干预措施：超声引导 PRP 注射到病理性肩部肌腱，靶向冈上肌。为受试者提供了标准化的拉伸和加强计划，并在干预后 4、8、12 和 24 周进行了随访，并在每个时间点收集了结果。

结果测量：轮椅使用者肩痛指数（WUSPI）；疼痛数值评定量表（NRS）；冈上肌腱病的体格检查和超声检查；5 分患者总体变化印象 (PGIC)。

结果：治疗后24周，WUSPI（69.9%，P<0.001）、NRS（49.6%，P<0.01）和体检分数（35.7%，P<0.01）下降。参与者报告说，由于治疗，他们的状态总体有所改善。没有发现不良事件，也没有观察到肌腱病超声标志物的变化。

结论：单次超声引导 PRP 注射到冈上肌腱，然后进行拉伸和强化锻炼计划，是安全的，并且在 24 周内改善了该样本的肩痛结果测量。缺乏盲法、短期随访和合适的对照组需要进行更大规模的随机对照试验。

试用注册： NCT01355549