Detailed Search Results
| Author/Association: | Mulroy SJ, Thompson L, Kemp B, Hatchett PP, Newsam CJ, Lupold DG, Haubert LL, Eberly V, Ge TT, Azen SP, Winstein CJ, Gordon J |
| Title: | Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial [with consumer summary] |
| Source: | Physical Therapy 2011 Mar;91(3):305-324 |
| Method: | clinical trial |
| Method Score: | 7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | THE BOTTOM LINE: WHAT DO WE ALREADY KNOW ABOUT THIS TOPIC: Shoulder pain is a common problem for patients after spinal cord injury (SPI). Untreated, shoulder pain may lead to additional losses in function and community mobility. Preliminary evidence suggests that shoulder strengthening and stretching exercises may reduce shoulder pain in patients with SCI. WHAT NEW INFORMATION DOES THIS STUDY OFFER: This randomized controlled trial demonstrated that a 12-week home exercise program, paired with instruction to optimize movement performance, will result in a significant and persistent reduction in shoulder pain as well as significant improvements in muscle strength and in health related and overall quality of life. IF YOU'RE A PATIENT, WHAT MIGHT THESE FINDINGS MEAN FOR YOU: Chronic shoulder pain after SCI can be markedly reduced by using a relatively simple home exercise program coupled with assessment and modification of performance technique for several upper-extremity weight-bearing activities. |
| Abstract: | BACKGROUND: Shoulder pain is a common problem after spinal cord injury (SCI), with negative effects on daily activities and quality of life (QOL). OBJECTIVE: 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. METHODS: 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. Full text (sometimes free) may be available at these link(s):  help |
