Article

Shoulder pain is a common problem after spinal cord injury (SCI),
with negative effects on daily activities and quality of life (QOL).
The purpose of this study was to determine the effect of an exercise program and
instruction to optimize performance of upper-extremity tasks on shoulder pain in
people with paraplegia from SCI. Design Eighty individuals with
paraplegia from SCI and shoulder pain were randomly assigned to receive either an
exercise/movement optimization intervention or an attention control intervention.
The exercise/movement optimization intervention consisted of a 12-week home-based
program of shoulder strengthening and stretching exercises, along with
recommendations on how to optimize the movement technique of transfers, raises,
and wheelchair propulsion. The attention control group viewed a 1-hour
educational video. Outcome measures of shoulder pain, muscle strength
(force-generating capacity), activity, and QOL were assessed at baseline,
immediately after intervention, and 4 weeks later. RESULTS: Shoulder pain, as
measured with the Wheelchair User's Shoulder Pain Index, decreased to one third
of baseline levels after the intervention in the exercise/movement optimization
group, but remained unchanged in the attention control group. Shoulder torques,
most 36-Item Short-Form Health Survey questionnaire (SF-36) subscale scores, and
QOL scores also were improved in the exercise/movement optimization group, but
not in the attention control group. Improvements were maintained at the 4-week
follow-up assessment. Limitations Many of the outcome measures were
self-reported, and the participant dropout rate was high in both groups.
Additional studies are needed to determine whether the results of this study can
be generalized to individuals with tetraplegia. CONCLUSIONS:
This home-based
intervention was effective in reducing long-standing shoulder pain in people with
SCI. The reduction in pain was associated with improvements in muscle strength and health-related and overall QOL.

Langue : ANGLAIS