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1.
Rotsalai Kanlayanaphotporn Adit Chiradejnant Roongtiwa Vachalathiti 《Archives of physical medicine and rehabilitation》2009,90(2):187-192
Kanlayanaphotporn R, Chiradejnant A, Vachalathiti R. The immediate effects of mobilization technique on pain and range of motion in patients presenting with unilateral neck pain: a randomized controlled trial.
Objective
To determine the immediate effects on both pain and active range of motion (ROM) of the unilateral posteroanterior (PA) mobilization technique on the painful side in mechanical neck pain patients presenting with unilateral symptoms.Design
Triple-blind, randomized controlled trial.Setting
Outpatient physical therapy, institutional clinic.Participants
Patients (N=60), 2 physical therapists, and 1 assessor involved in this study.Interventions
The patients were randomly allocated into either preferred or random mobilization group by using an opaque concealed envelope. The first therapist performed the screening, assessing, prescribing the spinal level(s), and the grade of mobilization. The second therapist performed the mobilization treatment according to their allocated group stated in an envelope. The assessor who was blind to the group allocation conducted the measurements of pain and active cervical ROM.Main Outcome Measures
Pain intensity, active cervical ROM, and global perceived effect were measured at baseline and 5 minutes posttreatment.Results
After mobilization, there were no apparent differences in pain and active cervical ROM between groups. However, within-group changes showed significant decreases in neck pain at rest and pain on most painful movement (P<0.001) with a significant increase in active cervical ROM after mobilization on most painful movement (P=0.002).Conclusions
The results of this study did not provide support for the preference of the unilateral PA mobilization on the painful side to the random mobilization. 相似文献2.
Purpose
This study investigated the immediate effects of audible joint sounds following a supine T3-T4 spinal thrust manipulation on the autonomic nervous system activity using a fully automated pupillometry system in patients with chronic neck pain. An additional aim was to determine if audible sounds as perceived by the therapist were associated with the reduction of pain following manipulation.Methods
One hundred subjects with chronic neck pain completed the study protocol. The Mann-Whitney U test was used to compare the change scores of the 3 measuring points between the one-pop and multiple-pop groups. Subjects were randomized into either a manipulation or a mobilization group. A method of automated pupillometry was used in this study to capture pupil responsiveness.Results
The analysis showed that there was no significant difference between the 2 groups (P > .05). The Kruskal-Wallis test was used to compare the median change scores between the mobilization, no-pop, and pop groups. The analysis showed that there was no statistically significant difference in the amount of change in pupil diameter between the 3 groups (P > .05).The Mann-Whitney U test demonstrated that the no-pop group (P = .031) and the multiple-pop group (P = .014) had a significant reduction of pain; however, it did not reach the minimal clinically significant level of 13 mm on the visual analog scale.Conclusions
The results of this study provided evidence that the presence of joint sounds does not influence the overall activity of the autonomic nervous system following a thrust manipulation or contribute to the reduction of pain in patients with chronic neck pain. 相似文献3.
Stoelb BL Carter GT Abresch RT Purekal S McDonald CM Jensen MP 《Archives of physical medicine and rehabilitation》2008,89(10):1933-1940
Stoelb BL, Carter GT, Abresch RT, Purekal S, McDonald CM, Jensen MP. Pain in persons with postpolio syndrome: frequency, intensity, and impact.
Objective
To describe the frequency, intensity, and impact of pain in persons with postpoliomyelitis syndrome (PPS).Design
Retrospective, cross-sectional survey.Setting
Community-based survey.Participants
Convenience sample of people with PPS.Interventions
Not applicable.Main Outcome Measures
Overall intensity and duration of pain, pain sites, pain interference, pain treatments, and relief provided by pain treatments.Results
A total of 91% (n=57) of the study participants (N=63) reported pain. The most frequently reported pain sites were the shoulders, lower back, legs, and hips. Participants reported pain intensity to be the greatest in the knees, legs, wrists, lower back, and head. Pain interfered most with sleep and with activities requiring a high level of musculoskeletal involvement. Respondents also reported pain problems that were more severe than those of the general population and than those of a sample of people with multiple sclerosis. Many treatments had been tried previously for pain, but continued use of treatments was reported by relatively few participants at the time of the survey.Conclusions
The findings indicate that pain is a persistent and common problem in persons with PPS, highlighting the need for effective and accessible pain treatments for this population. 相似文献4.
Saavedra-Hernández M Ssavedra-Hernández M Castro-Sánchez AM Fernández-de-Las-Peñas C Cleland JA Ortega-Santiago R Arroyo-Morales M 《Journal of manipulative and physiological therapeutics》2011,34(3):127-152
Objective
The purpose of this study was to identify the prognostic factors for individuals with mechanical neck pain likely to experience improvements in both pain and disability after the application of an intervention including cervical and thoracic spine thrust manipulations.Methods
Patients presenting with mechanical neck pain participated in a prospective single-arm trial. Participants underwent a standardized examination and then received a series of thrust manipulations directed toward the cervical, cervicothoracic, and thoracic spine. Participants were classified as having achieved a successful outcome at the second and third sessions based on their perceived recovery. Potential prognostic variables were entered into a stepwise logistic regression model to determine the most accurate set of variables for the prediction of treatment success.Results
Data from 81 subjects were included in the analysis, of which 50 experienced a successful outcome (61.7%). Five variables including pain intensity greater than 4.5 points; cervical extension less than 46°; presence of hypomobility at T1; a negative upper limb tension test and female sex were identified. If 4 of 5 variables were present (likelihood ratio, +1.9), the likelihood of success increased from 61.7% to 75.4%.Conclusions
This study identified several prognostic clinical factors that can potentially identify, a priori, patients with neck pain who are likely to experience a rapid response to the application of an intervention including both cervical and thoracic spine manipulations. However, no combination of the variables was able to dramatically increase the posttest probability. 相似文献5.
Jesus-Moraleida FR Ferreira PH Pereira LS Vasconcelos CM Ferreira ML 《Journal of manipulative and physiological therapeutics》2011,34(8):514-524
Objective
The purpose of this study was to analyze changes in the recruitment of the muscles longus colli (Lco) and sternocledomastoid (SCM) as measured by ultrasonography in patients with chronic neck pain before and immediately after a single cervical Maitland's posterior-anterior central mobilization technique.Methods
This was a cross-sectional, case-control research design study. Ultrasonographic images of Lco and SCM were taken in 31 patients with chronic neck pain and matched controls during the 5 phases of the craniocervical flexion test before and after a Maitland's posterior-anterior central mobilization session at the cervical spine. Changes in muscle thickness during the test were calculated to infer muscle recruitment. Separate analysis of variance models for each muscle was built.Results
Both groups showed increases in Lco and SCM recruitment between phases (F = 7.95, P < .001; F = 21.29, P < .001), with patients with chronic neck pain demonstrating lesser increases for Lco changes in thickness compared with controls, mainly at phase 5 (−0.09, P = .004; 95% confidence interval [CI], 0.03-0.15). After the mobilization, Lco recruitment increased more significantly in patients with chronic neck pain, and previous difference between groups in phase 5 was no longer significant (−0.07, P = .07; 95% CI, −0.14 to 0.01). The SCM recruitment decreased in phase 1 for patients with chronic neck pain (P = .01; 95% CI, −0.06 to −0.01).Conclusion
Cervical mobilization appeared to modulate neck muscles function by increasing deep muscle and reducing superficial muscles recruitment. 相似文献6.
7.
Cleland JA, Childs JD, Whitman JM. Psychometric properties of the Neck Disability Index and numeric pain rating scale in patients with mechanical neck pain.
Objective
To examine the psychometric properties including test-retest reliability, construct validity, and minimum levels of detectable and clinically important change for the Neck Disability Index (NDI) and the numeric rating scale (NRS) for pain in a cohort of patients with neck pain.Design
Single-group repeated-measures design.Setting
Outpatient physical therapy (PT) clinics.Participants
Patients (N=137) presenting to PT with a primary report of neck pain.Interventions
Not applicable.Main Outcome Measures
All patients completed the NDI and the NRS at the baseline examination and at a follow-up. At the time of the follow-up, all patients also completed the global rating of change, which was used to dichotomize patients as improved or stable. Baseline and follow-up scores were used to determine the test-retest reliability, construct validity, and minimal levels of detectable and clinically important change for both the NDI and NRS.Results
Test-retest reliability was calculated using an intraclass correlation coefficient (ICC) (NDI ICC=.50; 95% confidence interval [CI], .25-.67; NRS ICC=.76; 95% CI, .51-.87). The area under the curve was .83 (95% CI, .75-.90) for the NDI score and .85 (95% CI, .78-.93) for the NRS score for determining between stable and improved patients. Thresholds for the minimum clinically important difference (MCID) for the NDI were 19-percentage points and 1.3 for the NRS.Conclusions
Both the NDI and NRS exhibit fair to moderate test-retest reliability in patients with mechanical neck pain. Both instruments also showed adequate responsiveness in this patient population. However, the MCID required to be certain that the change in scores has surpassed a level that could be contributed to measurement error for the NDI was twice that which has previously been reported. Therefore the ongoing analyses of the properties of the NDI in a patient population with neck pain are warranted. 相似文献8.
Objectives
To determine inter-rater agreement on diagnostic category using the Mechanical Diagnosis and Therapy (MDT) classification system for neck pain. If the diagnostic category was derangement syndrome, inter-rater agreement on the subcategory and the directional preference of treatment was also determined.Design
Clinicians viewed videotaped MDT examinations of 20 patients with neck pain and rated the MDT diagnosis independently for each patient. If the diagnostic category was derangement syndrome, the subcategory and directional preference of treatment were also rated.Setting
Private physical therapy outpatient clinics and a university clinical laboratory.Participants
Fifty-four clinicians trained in MDT for neck pain from the USA and Canada, and 20 adult patients with neck pain.Main outcome measures
Inter-rater agreement for MDT diagnosis, derangement subcategory and directional preference of treatment was determined using Kappa and percentage agreement.Results
Overall, agreement was of moderate clinical significance for diagnosis [κ = 0.55, P < 0.001, confidence intervals (CI) 0.52 to 0.58, 67%], derangement subcategory (κ = 0.47, CI 0.44 to 0.50, P < 0.001; 63%) and directional preference of treatment (κ = 0.46, CI 0.43 to 0.49, P < 0.05; 70%).Conclusions
Clinicians trained in MDT for neck pain demonstrate moderate agreement when classifying the diagnostic category and treatment for neck pain. 相似文献9.
Michael D. Stubblefield Laura Manfield Elyn R. Riedel 《Archives of physical medicine and rehabilitation》2010,91(8):1278-1282
Stubblefield MD, Manfield L, Riedel ER. A preliminary report on the efficacy of a dynamic jaw opening device (Dynasplint Trismus System) as part of the multimodal treatment of trismus in patients with head and neck cancer.
Objective
To examine the effectiveness of a dynamic jaw opening device as part of a multimodal treatment strategy for trismus in patients with head and neck cancer.Design
Retrospective cohort study.Setting
Tertiary care cancer center.Participants
Patients with head and neck cancer and trismus (N=20).Intervention
All patients underwent assessment by a board-certified physiatrist and were referred to physical therapy for delivery of the DTS and instructed to progress use of the DTS to 30 minutes 3 times a day. Additional modalities for the treatment of trismus including pain medications and botulinum toxin injections were prescribed as clinically indicated.Main Outcome Measures
Change in maximal interincisal distance (MID) as documented in the medical record.Results
The use of the DTS as part of multimodal therapy including physical therapy, pain medications, and botulinum toxin injections as deemed clinically appropriate resulted in an overall improvement of the MID from 16.5mm to 23.5mm (P<.001). Patients who could comply with the treatment recommendations for DTS treatment did better than those who could not, with an improvement of the MID from 16mm to 27mm (P<.001) versus 17mm to 22mm (P=.88).Conclusions
The DTS is a safe and effective component of a multimodal strategy for improving trismus associated with head and neck cancer and its treatment. Further investigation is needed to determine the relative efficacy of the treatment modalities available for trismus including physical therapy and other jaw stretching devices. 相似文献10.
Objectives
A patient care model has been proposed linking patient assessment to diagnosis to treatment to outcomes. Validation of this method is required. McKenzie developed the mechanical diagnosis and therapy (MDT) process to diagnose neck pain and direct its treatment. No study known to the authors has determined the link between MDT diagnosis and treatment for neck pain. The objective of the current study was to determine inter-rater agreement on the link between MDT diagnosis and treatment for neck pain.Setting
Outpatient physical therapy clinics.Participants
Fifty-four clinician raters, 20 patients with neck pain.Design
Clinicians, MDT-trained for neck pain, viewed videotaped examinations of adult patients with neck pain and rated diagnosis and initial treatment.Main outcomes measures
Inter-rater agreement on the MDT diagnosis-treatment link and derangement-directional preference link.Results
Inter-rater agreement on the diagnosis-treatment link of derangement-directional preference and not derangement-no directional preference of treatment was with moderate clinical and statistical significance (κ = 0.46, 95% confidence interval 0.45-0.47; P < 0.001; 86% agreement). There was moderate agreement on derangement-directional preference for the ‘derangement-extension’ link (κ = 0.40, 95% confidence interval 0.38-0.41; P < 0.001) and ‘derangement-lateral’ link (κ = 0.45, 95% confidence interval 0.44-0.46; P < 0.001), but with poor agreement for the ‘derangement-flexion’ link (κ = 0.04, 95% confidence interval 0.02-0.05; P < 0.001).Conclusions
Clinicians trained in MDT for neck pain link diagnosis to initial treatment of patients with neck pain with moderate reliability, specifically using extension or laterally directed preference for treatment. The current study contributes towards validation of the diagnosis-treatment link of the MDT patient care model for neck pain. 相似文献11.
Pereira MJ Jull GA Treleaven JM 《Archives of physical medicine and rehabilitation》2008,89(6):1097-1102
Pereira MJ, Jull GA, Treleaven JM. Self-reported driving habits in subjects with persistent whiplash-associated disorder: relationship to sensorimotor and psychologic features.
Objectives
To study self-reported driving habits after whiplash injury and to determine any relation among self-reported driving habits, selected sensorimotor impairments, and psychologic features.Design
Repeated-measures, case-controlled.Setting
Tertiary institution.Participants
Subjects (n=30) with chronic whiplash and 30 asymptomatic controls.Interventions
Not applicable.Main Outcome Measures
The Driving Habits Questionnaire (composite driving tasks score), Neck Disability Index (NDI), 28-item General Health Questionnaire (GHQ-28), Impact of Events Scale−Revised (IES-R), Tampa Scale for Kinesiophobia, cervical range of motion, cervical joint position error, and smooth pursuit neck torsion test.Results
Subjects in the whiplash group had equal driving exposure and driving spaces (distances, locations) compared with control subjects but reported significantly more driving difficulty with most driving tasks (P<.01). There were no significant correlations between the composite driving tasks score and any of the sensorimotor impairments, but there were significant and moderate correlations between the composite driving task score and both pain and disability (NDI score, .518) and anxiety (GHQ-28 score, .518; IES-R score, .524).Conclusions
Persons with chronic whiplash have greater self-reported driving difficulty than controls, which appears to relate more to reported levels of pain and disability and psychologic stress than laboratory measures of features of cervical sensorimotor control. 相似文献12.
Nolet PS Côté P Cassidy JD Carroll LJ 《Journal of manipulative and physiological therapeutics》2011,34(6):348-355
Objective
The purpose of this study was to investigate the association between a lifetime history of a work-related neck injury and the development of troublesome neck pain in the general population.Methods
We formed a cohort of randomly sampled Saskatchewan adults with no or mild neck pain in September 1995. At baseline, participants were asked if they had ever injured their neck at work. Six and 12 months later, participants were asked if they had troublesome neck pain defined as grades II to IV on the Chronic Pain Grade Questionnaire. Multivariable Cox regression was used to estimate the association between a lifetime history of work-related neck injury and the onset of troublesome neck pain while controlling for age and sex.Results
Our cohort included 866 individuals at risk for developing troublesome neck pain. Of those, 73.8% (639/866) were followed up at 6 months, and 63.0% (546/866), at 1 year. We found a positive association between a history of a work-related neck injury and the onset of troublesome neck pain (age- and sex-adjusted hazard rate ratio [HRR], 2.4; 95% confidence interval, 1.3-4.7).Conclusion
Our analysis suggests that a lifetime history of work-related neck injury is associated with an increased risk of troublesome neck pain. Occupational neck injuries can lead to recurrent episodes of neck pain. 相似文献13.
de Camargo VM Alburquerque-Sendín F Bérzin F Stefanelli VC de Souza DP Fernández-de-las-Peñas C 《Journal of manipulative and physiological therapeutics》2011,34(4):211-220
Objective
The purpose of this study was to identify the immediate effects of a manipulation of C5/C6 level on electromyography (EMG) of the deltoid muscle and in pressure pain thresholds (PPTs) in patients with mechanical neck pain.Methods
Thirty-seven subjects with mechanical neck pain were randomly divided into 2 groups: manipulative group, which received a cervical spine manipulation targeted to C5/C6 segment, and a control group, which did not receive any procedure. Outcomes were EMG data of the deltoid muscle (rest, isometric contraction for 5 or 30 seconds, and isotonic contraction) and PPT over upper trapezius and deltoid muscles and C5 spinous process. They were assessed before and 5 minutes after treatment by a blinded assessor. A 3-way repeated-measures analysis of variance was used to examine the effects of the manipulation.Results
A significant group time interaction for MF at the beginning of isometric contraction for 30 seconds (F = 7.957, P = .006) was also found: the manipulative group experienced a greater increase in MF at the beginning of the isometric contraction than did the control group. A significant group time interaction was also found for root mean square during isometric contraction for 30 seconds (P = .003); however, changes were small. Patients within the manipulative group experienced an increase on PPT over the deltoid (P = .010) and C5 spinous process (P = .025), but not over upper trapezius (P = .776).Conclusions
Manipulation at C5/C6 level in the study participants seemed to increase EMG amplitude signal and fatigue resistance in a nonspinal (deltoid) muscle innervated by the same segment in patients with mechanical neck pain. However, these changes were relative small. An increase on PPT over those tissues innervated by the manipulated segment was also found after the manipulative procedure. 相似文献14.
Lew HL Lee EH Castaneda A Klima R Date E 《Archives of physical medicine and rehabilitation》2008,89(1):75-80
Lew HL, Lee EH, Castaneda A, Klima R, Date E. Therapeutic use of botulinum toxin type A in treating neck and upper-back pain of myofascial origin: a pilot study.
Objective
To determine the efficacy of botulinum toxin type A (BTX-A) in treating neck and upper-back pain of myofascial origin.Design
A randomized, double-blind, placebo-controlled pilot study.Setting
Outpatient physical medicine and rehabilitation clinic of a university-affiliated tertiary hospital.Participants
A total of 29 subjects enrolled from among 45 screened patients. No subject withdrawal due to serious adverse events occurred.Intervention
Subjects were evaluated at baseline, received a 1-time injection of either BTX-A (treatment group) or saline (control group), and were followed up at 2 weeks and at months 1, 2, 3, 4, and 6.Main Outcome Measures
Visual analog scale (VAS) for pain, the Neck Disability Index (NDI), and the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36).Results
Improvements in the VAS and NDI scores were seen in the treatment group but were not significant when compared with the controls. Statistically significant improvements for the treatment group were seen in the SF-36 bodily pain (at months 2 and 4) and mental health (at month 1) scales but not in the other scales, nor in the summary measures. No serious adverse events were reported.Conclusions
Trends toward improvements in VAS and NDI scores of the BTX-A group are encouraging, but they were possibly due to a placebo effect and were not statistically significant. The BTX-A subjects, at certain time points, showed statistically significant improvements in the bodily pain and mental health scales of the SF-36 compared with controls. Our study had limited power and population base, but the results could be used to properly power follow-up studies to further investigate this topic. 相似文献15.
Patient Participation and Physical Activity During Rehabilitation and Future Functional Outcomes in Patients After Hip Fracture 总被引:1,自引:0,他引:1
Jaime B. Talkowski Eric J. Lenze Michael C. Munin Chris Harrison Jennifer S. Brach 《Archives of physical medicine and rehabilitation》2009,90(4):618-622
Talkowski JB, Lenze EJ, Munin MC, Harrison C, Brach JS. Patient participation and physical activity during rehabilitation and future functional outcomes in patients after hip fracture.
Objective
To examine the association between physical activity recorded by actigraphy during therapy sessions (therapy) with therapist-rated patient participation and self-reported future functional outcomes. We hypothesized those participants who were more active during rehabilitation would have higher participation scores and better functional outcomes after hip fracture compared with those who were less active.Design
Longitudinal study with a 3- and 6-month follow-up.Setting
Participants were recruited from skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs).Participants
Participants included 18 community-dwelling older adults admitted to SNFs or IRFs facilities after hip fracture. Participants were included if they were 60 years of age or older and ambulatory with or without assistance from a device or another person.Interventions
Not applicable.Main Outcome Measures
Physical activity was quantified during participants' rehabiliation by using the actigraph accelerometer worn consecutively over 5 days. The Pittsburgh Participation Rating Scale was used to quantify patient participation during their inpatient therapy sessions. Self-reported functional outcomes were measured by the Hip Fracture Functional Recovery Scale at baseline and 3 and 6 months after fracture.Results
Participants with higher actigraphy counts during rehabilitation were ranked by their therapists as having excellent participation compared with those who were less active. Participants who were more active reported better functional abilities at both the 3- and 6-month time points and achieved 78% and 91% recovery of self-reported prefracture function compared with those who were less active achieving 64% and 73% recovery.Conclusions
Actigraphy provides an objective measure of physical activity exhibiting predictive validity for future functional outcomes and concurrent validity against patient participation in patients after hip fracture. 相似文献16.
Toby B. Cumming Prudence Plummer-D'Amato Thomas Linden Julie Bernhardt 《Archives of physical medicine and rehabilitation》2009,90(11):1931-1936
Cumming TB, Plummer-D'Amato P, Linden T, Bernhardt J. Hemispatial neglect and rehabilitation in acute stroke.
Objectives
To compare 2 methods for determining neglect in patients within 2 days of stroke, and to investigate whether early neglect was related to rehabilitation practice, and whether this relationship was affected by an early, intensive mobilization intervention.Design
Data were collected from patients participating in a phase II randomized controlled trial of early rehabilitation after stroke.Setting
Acute hospital stroke unit.Participants
Stroke patients (N=71).Intervention
The 2 arms of the trial were very early mobilization (VEM) and standard care (SC).Main Outcome Measures
Neglect was assessed using the Star Cancellation Test and the National Institutes of Health Stroke Scale (NIHSS) inattention item within 48 hours of stroke onset, and therapy details were recorded during the hospital stay.Results
Assessing neglect so acutely after stroke was difficult: 29 of the 71 patients were unable to complete the Star Cancellation Test, and agreement between this test and the NIHSS measure was only .42. Presence of neglect did not preclude early mobilization. SC group patients with neglect had longer hospital stays (median, 11d) than those without neglect (median, 4d); there was no difference in length of stay between patients with and without neglect in the VEM group (median, 6d in both).Conclusion
Early mobilization of patients with neglect was feasible and may contribute to a shorter acute hospital stay. 相似文献17.
18.
Objectives
To identify the extent to which an adapted pain management programme is successful in modifying pain beliefs, psychological distress, locus of control and self-efficacy using both qualitative and quantitative approaches.Design
Prospective, observational study with questionnaires at baseline and following completion of a pain management programme.Setting
Outpatient pain management programme in a district general hospital.Participants
Fifteen participants experiencing chronic pain, referred from pain and rheumatology clinics within the hospital.Outcome measures
Pain beliefs, self-efficacy, locus of control and psychological distress.Results
Wilcoxon signed ranks tests demonstrated significant improvements in pain beliefs, self-efficacy and psychological distress. However, changes in locus of control were not found to be significant. The qualitative data supported these findings.Conclusions
The pilot study suggested that the pain management programme successfully modified three out of four of the psychosocial risk factors (Yellow Flags) in a population with established pain and disability. A larger scale project replicating this pilot study including a comparison group, and further research to assess the extent to which modifying Yellow Flags generalises to affect quality of life and disability, are underway. 相似文献19.
Nash MS Koppens D van Haaren M Sherman AL Lippiatt JP Lewis JE 《Archives of physical medicine and rehabilitation》2008,89(11):2080-2085
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 injury.
Objective
Test effects of pushrim-activated power-assisted wheelchairs (PAPAWs) on the energetics and perceptual responses to steady-state and intensity-graded wheelchair propulsion in persons with paraplegia and tetraplegia having chronic shoulder pain.Design
Test, retest with a control condition.Setting
Academic medical center.Participants
Subjects (N=18) aged 19 to 70 years with chronic, motor-complete paraplegia and tetraplegia having confirmed shoulder pain.Interventions
Study participants underwent testing on 4 randomized nonconsecutive days during either 6 minutes of steady-state or 12 minutes of intensity-graded wheelchair propulsion on stationary rollers. Participants used their own manual wheelchair and either their customary wheels or power-assist wheels attached with an axle bracket.Main Outcome Measures
Oxygen consumption (V?o2, L/min), distance (m), energy cost (L/m), and ratings of perceived exertion (RPE; Borg Categorical 6-20 Scale) were measured during propulsion.Results
Significant main effects of testing were observed for V?o2, heart rate, and RPE in both subject groups. Distances propelled were significantly increased in both groups across both tests and in each of their 2-minute exercise stages.Conclusions
Use of PAPAWs by persons with paraplegia and tetraplegia having shoulder pain significantly lowers energy cost responses and perceived exertion compared with manual wheelchair propulsion while significantly increasing the distanced propelled. 相似文献20.