Study of Strengthening Exercises and Improving Movement for Painful Shoulders in Adults With Spinal Cord Injury
Condition: Shoulder Pain
MeSH terms: Shoulder Pain; Spinal Cord Injuries
Study type: Interventional
Phase: Phase 1

Summary: 
      The purpose of this study is to conduct research to see if we can help people who have a
      spinal cord injury and shoulder pain to decrease the pain in the shoulders. We are
      investigating the effectiveness of a home exercise program for the shoulders and changes in
      how tasks are performed compared to an educational program on shoulder pain. There are no new
      experimental procedures included in this study; instead it is a comparison of two types of
      treatment that have been provided for this problem before. The new part of this study is the
      collecting of information before and after treatment. We hypothesize that those who
      participate in this home exercise program will have decrease shoulder pain and increase
      activity.
    

Detailed description: 
      Adults who sustain a spinal cord injury (SCI) now have the potential to lead active,
      productive lives with near normal life expectancy. Recent studies have demonstrated that many
      people with SCI develop health and functional problems at earlier ages than their
      non-disabled peers, with symptoms often occurring between the mid-30's and the mid-50's.
      These symptoms and impairments include: pain, musculoskeletal problems, declining energy,
      loss of strength and new functional limitations. These are examples of the challenges people
      may face as they reach mid-life with a SCI. A prevalent impairment in the long-term SCI
      population is upper extremity pain. Both the incidence and severity of pain increase with
      longer duration of SCI. The impact of shoulder pain on function and independence after SCI
      can be significant and detrimental. Development of shoulder pain in the SCI population has
      been associated with the increased weight-bearing demand placed on the upper extremities for
      mobility, muscle imbalances in the shoulder girdle, poor postural alignment from trunk
      paralysis and the need to function from a seated position. The efficacy of specific
      interventions has not been fully investigated. Treatment effectiveness must be determined
      using measures that include the pain impairment (severity), the disability or functional
      limitation associated with pain, and the participation or handicap limitations associated
      with pain. The goal is to develop a program that has standardized resistance, requires little
      equipment, is simple to conduct and minimizes the time commitment required of the patient.
      The effect of the combined intervention on shoulder pain and function will be assessed with a
      randomized clinical trial comparing the intervention to an attention control group receiving
      generalized information regarding shoulder joint anatomy and pain management. Secondary goals
      of this study are to identify the critical muscle groups for which strength changes are
      associated with shoulder pain reduction and to determine the impact of the intervention on
      physical activity, health related quality of life and overall subjective quality of life.
    

Intervention name(s): Shoulder strengthening exercises; Movement Optimization
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single
Primary purpose: Treatment
Keywords: Shoulder pain; Chronic Spinal Cord Injury; Exercise; Physical therapy techniques; Motor performance