UNCOVERING NOVEL ASSOCIATIONS OF PHYSICAL ACTIVITY WITH SHOULDER PAIN AND DEPRESSION AMONG SPINAL CORD INJURY COMMUNITY IN KLANG VALLEY, MALAYSIA

Abstract

Background and Objective: Individuals with spinal cord injury (SCI) frequently experience shoulder pain and depressive symptoms, both of which negatively affect daily functioning and quality of life. Physical activity is commonly promoted to improve physical and psychological health; however, its relationship with pain and depression among individuals with SCI remains inconsistent, particularly in densely populated urban settings such as the Klang Valley, Malaysia. Urban environmental demands, accessibility, and psychosocial stressors may influence these relationships. This study aimed to examine the associations between physical activity levels, shoulder pain, and depressive symptoms among adults with SCI living in the Klang Valley, and to describe the overall levels of physical activity, pain, and depression in this population. Methods: A cross-sectional study was conducted among wheelchair-dependent adults with SCI aged 18–55 years residing in the Klang Valley. Participants were recruited using snowball sampling and completed face-to-face assessments. Sociodemographic and injury-related information was collected. Physical activity, shoulder pain, and depressive symptoms were assessed using validated Malay versions of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Wheelchair User’s Shoulder Pain Index (WUSPI), and Patient Health Questionnaire-9 (PHQ-9), respectively. Spearman’s rank correlation was used to examine associations between variables. Results: Eighteen participants were included in the analysis. No significant associations were found between physical activity and shoulder pain (ρ = –0.030, p = 0.904) or between physical activity and depressive symptoms (ρ = 0.105, p = 0.679). Years since injury were also not significantly related to pain or depression. Overall, participants demonstrated moderate physical activity levels, variable shoulder pain intensity, and predominantly minimal depressive symptoms. Conclusion: Physical activity alone did not predict shoulder pain or depressive symptoms among urban-dwelling individuals with SCI in the Klang Valley. These findings suggest that environmental and psychosocial factors may play an important role. Larger, longitudinal studies are needed to clarify these relationships and inform context-specific rehabilitation strategies.