@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2018;10(1):27-31
ISSN: 2008-2630 Iranian Journal of War & Public Health 2018;10(1):27-31
Effect of Shoulder Centralized Exercises and Pushrim-Activated Power-Assisted Wheelchair (PAPAW) on Pain and Shoulder Function in Veterans with Paraplegic Spinal Cord Injury
ARTICLE INFO
Article Type
Original ResearchAuthors
Babakhani F. (*)Balouchi R. (1)
Vahidian M.R. (1)
(*) Sport Pathology & Corrective Exercises Department, Physical Education & Sport Sciences Faculty, Allameh Tabataba’i University, Tehran, Iran
(1) Sport Pathology & Corrective Exercises Department, Physical Education & Sport Sciences Faculty, Allameh Tabataba’i University, Tehran, Iran
Correspondence
Address: Physical Education & Sport Sciences Faculty, Allameh Tabataba'i University, Olampik Square, Dehkade-ye Olampik, West Hemmat Highway, Tehran, IranPhone: +98 (21) 44737510
Fax: +98 (21) 44118635
farideh_babakhani@yahoo.com
Article History
Received: June 26, 2017Accepted: October 25, 2017
ePublished: January 11, 2018
ABSTRACT
Aims
Spinal cord injury is an acute and devastating event that causes significant and permanent changes in veterans’ life and leads to functional impairments. Exercise can reduce the incapacity or improve individuals’ functions. The aim of this study was to investigate the effect of shoulder centralized exercises and Pushrim-Activated Power-Assisted Wheelchair (PAPAW) on pain and shoulder function in veterans with paraplegic spinal cord injury.
Materials & Methods In this semi-experimental study with pre-test and post-test design, 20 wheelchair-user veterans with spinal cord injury and shoulder pain referring to Kosar orthosis and prosthesis center were selected by purposive sampling in 2015. They were randomly assigned into experimental (n=10) and control (n=10) groups. Data were collected by Wheelchair User's Shoulder Pain Index (WUSPI) and Shoulder Rating Questionaire (SRQ). The exercises were performed for 8 weeks and 3 days each week in the experimental group with using Pushrim-Activated Power-Assisted Wheelchair (PAPAW) at home and the control group did not receive any interventions. Data were analyzed by dependent t-test and Analysis of Covariance (ANCOVA).
Findings In the experimental group, the pain level significantly decreased and the shoulder function significantly increased in the post-test compared to the pre-test. There was a significant difference between experimental and control groups (p<0.05).
Conclusion Shoulder centralized exercises and Pushrim-Activated Power-Assisted Wheelchair (PAPAW) is effective on decreasing the pain and increasing shoulder function in veterans with paraplegic spinal cord injury.
Materials & Methods In this semi-experimental study with pre-test and post-test design, 20 wheelchair-user veterans with spinal cord injury and shoulder pain referring to Kosar orthosis and prosthesis center were selected by purposive sampling in 2015. They were randomly assigned into experimental (n=10) and control (n=10) groups. Data were collected by Wheelchair User's Shoulder Pain Index (WUSPI) and Shoulder Rating Questionaire (SRQ). The exercises were performed for 8 weeks and 3 days each week in the experimental group with using Pushrim-Activated Power-Assisted Wheelchair (PAPAW) at home and the control group did not receive any interventions. Data were analyzed by dependent t-test and Analysis of Covariance (ANCOVA).
Findings In the experimental group, the pain level significantly decreased and the shoulder function significantly increased in the post-test compared to the pre-test. There was a significant difference between experimental and control groups (p<0.05).
Conclusion Shoulder centralized exercises and Pushrim-Activated Power-Assisted Wheelchair (PAPAW) is effective on decreasing the pain and increasing shoulder function in veterans with paraplegic spinal cord injury.
CITATION LINKS
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[12]Yildirim NU, Comert E, Ozengin N. Shoulder pain: A comparison of wheelchair basketball players with trunk control and without trunk control. J Back Musculoskelet Rehabil. 2010;23(2):55-61.
[13]Mousavi SJ, Parnianpour M, Abedi M, Askary-Ashtiani A, Karimi A, Khorsandi A, et al. Cultural adaptation and validation of the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Clin Rehabil. 2008;22(8):749-57.
[14]Babakhani F, Sheikhhoseini R, Amjad A. Effectiveness of one period selected resistance training on shoulder strength, pain and function in wheelchair users with impingement syndrome of shoulder. J Shahid Sadoughi Univ Med Sci. 2017;25(2):91-100.
[15]Arva J, Fitzgerald SG, Cooper RA, Boninger ML. Mechanical efficiency and user power requirement with a pushrim activated power assisted wheelchair. Med Eng Phys. 2001;23(10):699-705.
[16]Nash MS, Koppens D, Van Haaren M, Sherman AL, Lippiatt JP, Lewis JE. Power-assisted wheels ease energy costs and perceptual responses to wheelchair propulsion in persons with shoulder pain and spinal cord injur. Arch Phys Med Rehabil. 2008;89(11):2080-5.
[17]Kloosterman MG, Eising H, Schaake L, Buurke JH, Rietman JS. Comparison of shoulder load during power-assisted and purely hand-rim wheelchair propulsion. Clin Biomech (Bristol, Avon). 2012;27(5):428-35.
[18]Meron A, Saint-Phard D. Track and field throwing sports: Injuries and prevention. Curr Sports Med Rep. 2017;16(6):391-6.
[19]Judy RP, Shin JJ, McCrum C, Ayeni OR, Samuelsson K, Musahl V. Level of evidence and authorship trends of clinical studies in knee surgery, sports traumatology, arthroscopy, 1995-2015. Knee Surg Sports Traumatol Arthrosc. 2017;14. DOI: 10.1007/s00167-017-4801-6.
[20]Veigel JD, Pleacher MD. Injury prevention in youth sports. Curr Sports Med Rep. 2008;7(6):348-52.
[21]Fullerton HD, Borckardt JJ, Alfano AP. Shoulder pain: A comparison of wheelchair athletes and nona-thletic wheelchair users. Med Sci Sports Exerc. 2003;35(12):1958-61.
[22]Kemp BJ, Bateham AL, Mulroy SJ, Thompson L, Adkins RH, Kahan JS. Effects of reduction in shoulder pain on quality of life and community activities among people living long-term with SCI paraplegia: A randomized control trial. J Spinal Cord Med. 2011;34(3):278-84.
[23]Rahmani H, Shahrokhi H, Daneshmandi H. The compression of shoulder pain and strength and relationship between them in wheelchair veterans athletes and non-athletes. J War Public Health. 2012;4(4):49-56. [Persian]
[24]Mulroy S, Thompson L, Kemp B. Hatchett PP, Newsam CJ, Lupold DG. Strengthening and Optimal Movements for Painful Shoulders (STOMPS) in Chronic Spinal Cord Injury. A Randomized Controlled Trial. Physical Ther J. 2011;91(3):305-24.
[25]Erol O, Ozçakar L, CelikerR. Shoulder rotator strength in patients with stage I-II subacromial impingement: Relationship to pain, disability, and quality of life. J Shoulder Elbow Surg. 2008;17(6):893-7.
[26]Letafatkar A, Abdolvahabi Z. General Corrective Exercises with corrective exercises. Tehran: Publications Avay zohur. 2010. pp. 110-60. [Persian]
[2]Gironda RJ, Clark ME, Neugaard B, Nelson A. Upper limb pain in a national sample of veterans with paraplegia. J Spinal Cord Med. 2004;27(2):120-7.
[3]Kashi A. Problem pain after spinal cord [Internet]. Tehran: Center for Spinal Diseases of Veterans; c2010 [updated 2016 Nov 20; cited 2010]. Available from: http://www.isaarsci.ir/eduartsci%20folder/eduar tsci2htm. [Persian]
[4]Danesh Afrooz N. Orthotics in neurological rehabilitation. Tehran: Publications Janbazan Medical and Engineering Research center; 2010. pp. 161-85. [Persian]
[5]Bjerkefors A. Performance and trainability in Paraplegics- motor function, shoulder muscle strength and sitting balance befor and after Kayak ergometer training [Dissertation]. Stockholm: Karolinska Institutet; 2006. pp. 38-42.
[6]Burnham RS, May L, Nelson E, Steadward R, Reid DC. Shoulder pain in wheelchair athletes. The role of muscle imbalance. Am J Sports Med. 1993;21(2):238-42.
[7]Khani H, Zamani N, Ghorbani A, Jahangir AH, Jenaabadi H. Mental health status of amputee veterans; Mazandaran Province, Iran. Iran J War Public Health. 2016;8(3):149-56. [Persian]
[8]Lee TQ, McMahon PJ. Shoulder biomechanics and muscle plasticity: Implications in spinal cord injury. Clin Orthop Relat Res. 2002;(403 suppl):26-36.
[9]Boninger ML, Koontz AM, Sisto SA, Dyson-Hudson TA, Chang M, Price R, Cooper RA. Pushrim biomechanics and injury prevention in spinal cord injury: Recommendations based on CULP-SCI investigations. J Rehabilit Res Dev. 2005;42(Suppl 3):9-19.
[10]Curtis KA, Roach KE, Applegate EB, Amar T, Benbow CS, Genecco TD, Gualano J. Development of the wheelchair user's shoulder pain index (WUSPI). Paraplegia. 1995;33(5):290-3.
[11]Salisbury SK, Nitz J, Souvlis T. Shoulder pain following tetraplegia: A follow-up study 2-4 years after injury. Spinal Cord. 2006;44(12):723-8.
[12]Yildirim NU, Comert E, Ozengin N. Shoulder pain: A comparison of wheelchair basketball players with trunk control and without trunk control. J Back Musculoskelet Rehabil. 2010;23(2):55-61.
[13]Mousavi SJ, Parnianpour M, Abedi M, Askary-Ashtiani A, Karimi A, Khorsandi A, et al. Cultural adaptation and validation of the Persian version of the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Clin Rehabil. 2008;22(8):749-57.
[14]Babakhani F, Sheikhhoseini R, Amjad A. Effectiveness of one period selected resistance training on shoulder strength, pain and function in wheelchair users with impingement syndrome of shoulder. J Shahid Sadoughi Univ Med Sci. 2017;25(2):91-100.
[15]Arva J, Fitzgerald SG, Cooper RA, Boninger ML. Mechanical efficiency and user power requirement with a pushrim activated power assisted wheelchair. Med Eng Phys. 2001;23(10):699-705.
[16]Nash MS, Koppens D, Van Haaren M, Sherman AL, Lippiatt JP, Lewis JE. Power-assisted wheels ease energy costs and perceptual responses to wheelchair propulsion in persons with shoulder pain and spinal cord injur. Arch Phys Med Rehabil. 2008;89(11):2080-5.
[17]Kloosterman MG, Eising H, Schaake L, Buurke JH, Rietman JS. Comparison of shoulder load during power-assisted and purely hand-rim wheelchair propulsion. Clin Biomech (Bristol, Avon). 2012;27(5):428-35.
[18]Meron A, Saint-Phard D. Track and field throwing sports: Injuries and prevention. Curr Sports Med Rep. 2017;16(6):391-6.
[19]Judy RP, Shin JJ, McCrum C, Ayeni OR, Samuelsson K, Musahl V. Level of evidence and authorship trends of clinical studies in knee surgery, sports traumatology, arthroscopy, 1995-2015. Knee Surg Sports Traumatol Arthrosc. 2017;14. DOI: 10.1007/s00167-017-4801-6.
[20]Veigel JD, Pleacher MD. Injury prevention in youth sports. Curr Sports Med Rep. 2008;7(6):348-52.
[21]Fullerton HD, Borckardt JJ, Alfano AP. Shoulder pain: A comparison of wheelchair athletes and nona-thletic wheelchair users. Med Sci Sports Exerc. 2003;35(12):1958-61.
[22]Kemp BJ, Bateham AL, Mulroy SJ, Thompson L, Adkins RH, Kahan JS. Effects of reduction in shoulder pain on quality of life and community activities among people living long-term with SCI paraplegia: A randomized control trial. J Spinal Cord Med. 2011;34(3):278-84.
[23]Rahmani H, Shahrokhi H, Daneshmandi H. The compression of shoulder pain and strength and relationship between them in wheelchair veterans athletes and non-athletes. J War Public Health. 2012;4(4):49-56. [Persian]
[24]Mulroy S, Thompson L, Kemp B. Hatchett PP, Newsam CJ, Lupold DG. Strengthening and Optimal Movements for Painful Shoulders (STOMPS) in Chronic Spinal Cord Injury. A Randomized Controlled Trial. Physical Ther J. 2011;91(3):305-24.
[25]Erol O, Ozçakar L, CelikerR. Shoulder rotator strength in patients with stage I-II subacromial impingement: Relationship to pain, disability, and quality of life. J Shoulder Elbow Surg. 2008;17(6):893-7.
[26]Letafatkar A, Abdolvahabi Z. General Corrective Exercises with corrective exercises. Tehran: Publications Avay zohur. 2010. pp. 110-60. [Persian]