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A multi-centre, randomized controlled trial of the effectiveness of positioning on quadriplegic shoulder pain
Crowe J, MacKay-Lyons M, Morris H
Physiotherapy Canada 2000 Fall;52(4):266-273
clinical trial
6/10 [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: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND AND PURPOSE: Retrospective studies indicate a high incidence of shoulder pain in patients in the acute stage after cervical spinal cord injury. The purpose was to evaluate the effectiveness of positioning in reducing shoulder pain. METHODS: Subjects were patients with quadriplegia. Subjects were randomly assigned to receive conventional care (including glenohumeral and scapular range of motion (ROM)) or conventional care plus regular positioning. Outcomes measured included weekly ROM and pain. On transfer to rehabilitation, and at 3 months after onset Functional Independence Measures (FIM) were obtained. Baseline data were compared using Chi square and un-paired t tests. Outcomes were compared using repeated measure analysis of covariance (pain, ROM) and unpaired t tests for FIM. RESULTS: There were no significant differences between treatment groups. CONCLUSIONS: Shoulder pain in this population was as little as that reported in previous retrospective studies and may be due to the rigorous, early ROM, with this amount of positioning providing no additional benefit.

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