Table 1

Summary of the study

Phase 1Phase 2Phase 3
ObjectivesTo determine:
  1. The presence of musculoskeletal pain.

  2. The presence of neuropathic pain.

  3. The association of musculoskeletal shoulder pain and the following internal factors: (a) pectoralis minor muscle length b) scapular dyskinesis.

  4. The impact of pain on wheelchair function.

  5. The impact of pain on QOL.

  6. The impact of pain on community reintegration.

  7. The risk of pain medication misuse.

  8. The sociodemographic and injury profile of MWUs who complain of pain.

  1. To ascertain how MWUs experience life with the presence of pain.

  2. To determine strategies used by MWUs to cope with the pain.

  3. To determine how MWUs feel pain may affect their future if at all.

  4. To obtain suggestions from MWUs on how pain management programmes can be enhanced.

The objective is to use the results of phase 1 and phase 2 to guide the development of a framework for the self-management of pain.
Source of participantsPatient records (databases) of five hospitals and rehabilitation units that admit PWSCIMWUs who report the presence of pain in phase 1SCI network from SASCA, pain management and neurology rehabilitation special interest groups of SASP and PainSA
DesignQuantitative, cross-sectional designQualitative, descriptive contextual designModified Delphi study
ParticipantsMWUs with T2 paraplegia and belowMWUs who reported the presence of pain in phase 1Health professionals in the field of SCI rehabilitation and pain management in both academia and clinical care.
SettingParticipants’ homes or private officesOnline platform: REDCap
Sample size115 MWUs15–20 until data saturation is metSeven to 14
Inclusion criteriaAll consenting MWUs irrespective of type, cause and completeness of SCI.MWUs must report the presence of painHealth professionals in academia: PhD or near completion
Health professionals in clinical care: 10 years experience in their respective fields
Exclusion criteriaMWUs readmitted during the data collection periodIncomplete interviewsIncomplete ratings at the end of the data collection period
Procedures and instrumentationOutcome measures described in table 1Individual, in-depth, semistructured interviews recorded on a digital recorderScoring of the items in the proposed framework
Data analysisDescriptive statistics
Appropriate tests of association
Instrumental-variables regression using multivariable logistic regression.
Identify substantive statements
Cross-case analysis
Separate coding done to identify themes, subthemes and categories
In three components:
First component: consensus agreement
Second component: importance agreement
Third component: rotational modification to the Delphi process
  • .MWUs, manual wheelchair users; PhD, doctor of philosophy; PWSCI, people with spinal cord injury; QOL, quality of life; SASCA, Southern African Spinal Cord Association; SASP, South African Society of Physiotherapy; SCI, spinal cord injury.