Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users

Spinal Cord. 1999 Jun;37(6):421-9. doi: 10.1038/sj.sc.3100860.


Purpose: To analyze the effectiveness of a 6-month exercise protocol on shoulder pain experienced by wheelchair users during functional activities.

Subjects: Forty-two wheelchair users, 35 males and seven females: average age of 35 years and an average duration of wheelchair use of 14 years.

Methods: Subjects were randomly assigned to treatment (n=21) and control (n=21) groups. The treatment group received instruction in five shoulder exercises which they performed daily for 6 months. The exercise protocol included two exercises for stretching anterior shoulder musculature and three exercises for strengthening posterior shoulder musculature.

Outcome measures: All subjects completed a self-report questionnaire and the Wheelchair Users Shoulder Pain Index (WUSPI) initially and at bimonthly intervals during the 6-month intervention.

Results: Seventy-five per cent of the subjects reported a history of shoulder pain since beginning wheelchair use. The average initial performance-corrected (PC-WUSPI) score of the 42 subjects was 17.7 (+/-21.3) with a range of 0-103.2 points. Over 83% of the subjects (35 of 42) completed the 6-month study. Subjects in the treatment group decreased their PC-WUSPI score by an average of 39.9%, compared to decreases of only 2.5% in the control group.

Conclusions: These findings supported the effectiveness of this exercise protocol in decreasing the intensity of shoulder pain which interferes with functional activity in wheelchair users.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Analysis of Variance
  • Chi-Square Distribution
  • Disabled Persons*
  • Exercise Therapy / standards*
  • Female
  • Humans
  • Male
  • Pain Measurement
  • Pilot Projects
  • Shoulder Pain / etiology
  • Shoulder Pain / physiopathology
  • Shoulder Pain / therapy*
  • Spinal Cord Injuries / physiopathology
  • Surveys and Questionnaires
  • Wheelchairs*