The following article has just been accepted for publication in Journal of Neurologic Physical Therapy:
“Effectiveness of Exercise Programs for Management of Shoulder Pain in Manual Wheelchair Users with Spinal Cord Injury: A Systematic Review”
Kimberle A. Cratsenberg, P.T., D.P.T.; Cassandra E. Deitrick, P.T., D.P.T.; Taylor K. Harrington, P.T., D.P.T.; Natasha R. Kopecky, P.T., D.P.T.; Bradley D. Matthews, P.T., D.P.T.; Lauren M. Ott, P.T., D.P.T.; Remy R. Coeytaux, M.D., Ph.D.
Background/Purpose: Shoulder pain is prevalent in manual wheelchair users (MWUs) with spinal cord injury (SCI). Therapeutic exercise has been demonstrated to be an effective, conservative approach to treating shoulder pain in able-bodied individuals. We sought to evaluate literature on the effectiveness of exercise programs on the reduction of shoulder pain in MWUs with SCI.
Methods: We searched the literature using search terms related to SCI, manual wheelchairs, and shoulder pain. Eligibility criteria included: prospective study design, exercise intervention for MWUs with shoulder pain, and use of the Wheelchair User’s Shoulder Pain Index (WUSPI) as an outcome measure. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed study quality using the checklist proposed by Downs and Black.
Results: Three randomized control trials and four cohort studies met inclusion criteria. Two studies were rated as good quality and five as fair quality. Three interventions were evaluated in the included studies: arm ergometry, resistive strengthening with or without EMG biofeedback, and stretching that targeted the shoulder girdle. Across the seven studies, the exercise intervention was associated with reduction in shoulder pain that exceeded the estimated minimal detectable change of 5.10 points for the WUSPI.
Discussion/Conclusion: Exercise is a feasible, conservative, therapeutic intervention for the treatment of shoulder pain among MWUs. Additional studies are needed to differentiate techniques for the reduction of shoulder pain, to determine the most effective duration of intervention, and to estimate the magnitude of effect associated with therapeutic exercise for shoulder pain among MWUs.
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