Arm crank ergometry and shoulder pain in persons with spinal cord injury

Dyson-Hudson TA, Sisto SA, Bond Q, Emmons R, Kirshblum SC. Arm crank ergometry and shoulder pain in persons with spinal cord injury.

Objective

To determine whether a primary fitness program utilizing arm crank ergometry would cause increased shoulder pain in persons with spinal cord injury (SCI).

Design

Cohort study.

Setting

Clinical research center.

Participants

People (N=23) with chronic SCI (>1y) who were participating in a weight loss study to compare the effectiveness of diet only (1000kcal/d for 12wk) versus diet with arm crank ergometry (1000kcal/d and arm crank ergometry 3 times a week for 12wk).

Intervention

Arm crank ergometry.

Main Outcome Measure

Changes in shoulder pain intensity using the Wheelchair User’s Shoulder Pain Index (WUSPI).

Results

After adjusting for baseline scores, there was no significant difference between the 2 groups on postintervention WUSPI scores (F_1,20=.85, P=.37, partial η²=.04). The strength of the relationship between group assignment (diet only vs diet and arm crank ergometry) and final WUSPI score was weak, as assessed by a partial η², with group assignment accounting for 4% of the variance on the WUSPI. The adjusted means were lower in the diet and arm crank ergometry group (mean, 7.84) than in the diet only group (mean, 12.22); however, these differences did not appear to be clinically significant.

Conclusions

A primary fitness program using arm crank ergometry does not increase shoulder pain in people with SCI who use wheelchairs. Further investigation with a larger group and what constitutes clinically significant changes on the WUSPI is warranted to confirm our results.