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Effects of PNF on Shoulder Pain in Paraplegic Manual Wheel Chair Users

Primary Purpose

Shoulder Impingement

Status

Completed

Phase

Not Applicable

Locations

Pakistan

Study Type

Interventional

Intervention

Rhythmic stabilization exercises

conventional treatment

About this trial

This is an interventional treatment trial for Shoulder Impingement focused on measuring Spinal cord injury, wheelchair users, Shoulder pain, PNF

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

18-60 years old paraplegic manual wheel chair users after spinal cord injury.
Those having level of injury from C7-T12
Patients who are using wheelchair from more than one year.
Pain perceived region of one or both Shoulder from last three months or more
Pain without radicular symptoms radiating to whole upper limbs.
Wheelchair propulsion in activities of daily living,
Individuals with positive Neer's test and Hawkins-Kennedy test

Exclusion Criteria:

Any red flags (tumor, fracture, metabolic diseases, rheumatoid arthritis, resting blood pressure greater than 140/90 mmHg, prolonged history of steroid use, etc.
Any dislocation ,muscular tear and acute problem of shoulder.
Presented with a diagnosis of cervical spinal stenosis, exhibited bilateral upper extremity symptoms
Any recent surgery of the shoulder
Individuals using other mobility devices with wheelchair.
Individuals with primary impingement

Sites / Locations

Mansoora hospital, Lahore, Spine welfare centre, Social security hosital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Rhythmic stabilization exercises

Conventional treatment

Arm Description

baseline physical therapy conventional treatment along Rhythmic stabilization exercises

Baseline physical therapy conventional treatment

Outcomes

Primary Outcome Measures

Wheelchair User's Shoulder Pain Index

The Wheelchair User's Shoulder Pain Index (WUSPI) was designed to measure shoulder pain in individuals who use wheelchairs. On the visual analog scale from ' 0' to '10 ' estimate level of pain with different activities

Secondary Outcome Measures

Shoulder rating Questionnaire

Shoulder rating questionnaire (SRQ) was designed to assess the severity of symptoms related to and the functional status of the shoulder. It includes domains of global assessment, pain, daily activities, recreational and athletic activities, work, satisfaction, and areas for improvement. Each domain is graded separately and is weighted to arrive at the total score

Full Information

NCT ID

NCT04967911

First Posted

July 19, 2021

Last Updated

July 19, 2021

Sponsor

Riphah International University

1. Study Identification

Unique Protocol Identification Number

NCT04967911

Brief Title

Effects of PNF on Shoulder Pain in Paraplegic Manual Wheel Chair Users

Official Title

Effects of Propioceptive Neuromuscular Facilitation Technique on Shoulder Pain in Paraplegic Manual Wheel Chair Users After Spinal Cord Injury

Study Type

Interventional

2. Study Status

Record Verification Date

July 2021

Overall Recruitment Status

Completed

Study Start Date

November 30, 2020 (Actual)

Primary Completion Date

May 30, 2021 (Actual)

Study Completion Date

June 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title

Sponsor

Name of the Sponsor

Riphah International University

4. Oversight

Studies a U.S. FDA-regulated Drug Product

Studies a U.S. FDA-regulated Device Product

Data Monitoring Committee

5. Study Description

Brief Summary

This project was a Randomized control trial conducted to check the Effects of Proprioceptive Neuromuscular Facilitation on Shoulder Pain due to chronic impingement syndrome in paraplegic Manual Wheelchair users after Spinal Cord Injury so that we can have best treatment option for patients with shoulder pain due to manual wheelchair usage. duration was of 6months,convenient sampling was done, subject following eligibility criteria from Spine welfare trust center, Nawaz Sharif social security Hospital were randomly allocated in two groups via lottery method, Group A participants were given baseline treatment along with PNF exercises , Group B participants were given baseline treatment upto 6 weeks and 3 sessions per, post intervention assessment was done after 6 weeks, by self-generated questionnaire (WUSPI) wheel chair users shoulder pain index, (SRQ) Shoulder rating questionnaire and physical assessment by 2 special test was done, data was analyzed by using SPSS version 25.

Detailed Description

In paraplegic manual wheelchair users Shoulder pain is most common problem after spinal cord injury. Due to wheelchair propulsion, weight relief task and other household activities repetitive load induced on upper limb and put substantial load in particular on shoulder.In spinal cord injured patients shoulder pain is because of over use of upper limb and shoulder during wheelchair related activities and personal care activities. less stability and slight muscle mass leads toward pain in their life at some point because of Muscular imbalance and later on shoulder secondary impingement syndrome. This study compared the rhythmic stabilization technique from PNF exercises with conventional treatment on experimental and control group to see the difference in reduction of pain and disability.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study

Shoulder Impingement

Keywords

Spinal cord injury, wheelchair users, Shoulder pain, PNF

7. Study Design

Primary Purpose

Treatment

Study Phase

Not Applicable

Interventional Study Model

Parallel Assignment

Masking

Outcomes Assessor

Allocation

Randomized

Enrollment

22 (Actual)

8. Arms, Groups, and Interventions

Arm Title

Rhythmic stabilization exercises

Arm Type

Experimental

Arm Description

baseline physical therapy conventional treatment along Rhythmic stabilization exercises

Arm Title

Conventional treatment

Arm Type

Other

Arm Description

Baseline physical therapy conventional treatment

Intervention Type

Other

Intervention Name(s)

Rhythmic stabilization exercises

Intervention Description

PNF techniques and Conventional Treatment: Experimental group received rhythmical Stabilization Technique on shoulder joint on all shoulder movements up to 1 minute in supine position For stability of joint ,re-establish dynamic rotator cuff stability and to enhance MS strength and decrease pain. Conventional Treatment: heating pad for 15 minutes, TENS (Transcutaneous Electrical Nerve Stimulation) and after that shoulder stretching of upper trapezius muscle, pectorals and levator scapule and isometric exercises of rotator cuff muscles performed in supine .( 10 sec hold and 10 to 15 reps)..

Intervention Type

Other

Intervention Name(s)

conventional treatment

Intervention Description

Conventional Treatment: heating pad for 15 minutes, TENS (Transcutaneous Electrical Nerve Stimulation) and after that shoulder stretching of upper trapezius muscle, pectorals and levator scapule and isometric exercises of rotator cuff muscles performed in supine .( 10 sec hold and 10 to 15 reps)..

Primary Outcome Measure Information:

Title

Wheelchair User's Shoulder Pain Index

Description

Time Frame

6th Week

Secondary Outcome Measure Information:

Title

Shoulder rating Questionnaire

Description

Time Frame

6th Week

10. Eligibility

Sex

All

Minimum Age & Unit of Time

18 Years

Maximum Age & Unit of Time

60 Years

Accepts Healthy Volunteers

Eligibility Criteria

Inclusion Criteria: 18-60 years old paraplegic manual wheel chair users after spinal cord injury. Those having level of injury from C7-T12 Patients who are using wheelchair from more than one year. Pain perceived region of one or both Shoulder from last three months or more Pain without radicular symptoms radiating to whole upper limbs. Wheelchair propulsion in activities of daily living, Individuals with positive Neer's test and Hawkins-Kennedy test Exclusion Criteria: Any red flags (tumor, fracture, metabolic diseases, rheumatoid arthritis, resting blood pressure greater than 140/90 mmHg, prolonged history of steroid use, etc. Any dislocation ,muscular tear and acute problem of shoulder. Presented with a diagnosis of cervical spinal stenosis, exhibited bilateral upper extremity symptoms Any recent surgery of the shoulder Individuals using other mobility devices with wheelchair. Individuals with primary impingement

Overall Study Officials:

First Name & Middle Initial & Last Name & Degree

Mehwish Ikram, MS

Organizational Affiliation

Riphah International University

Official's Role

Principal Investigator

Facility Information:

Facility Name

Mansoora hospital, Lahore, Spine welfare centre, Social security hosital

City

Lahore

State/Province

Punjab

Country

Pakistan

12. IPD Sharing Statement

Plan to Share IPD

Citations:

PubMed Identifier

32397819

Citation

Mason B, Warner M, Briley S, Goosey-Tolfrey V, Vegter R. Managing shoulder pain in manual wheelchair users: a scoping review of conservative treatment interventions. Clin Rehabil. 2020 Jun;34(6):741-753. doi: 10.1177/0269215520917437. Epub 2020 May 12.

Results Reference

background

Citation

El Essi K, El-Shafie JM, Al Hawamdah Z, Zaqout SI. Shoulder Pain among Rehabilitated Spinal Cord Injured Persons Using Manually Propelled Wheelchairs in the Gaza Strip: A Survey. Disabil CBR Incl Dev. 2012;23(2):53-71.

Results Reference

background

PubMed Identifier

31046007

Citation

Soo Hoo J. Shoulder Pain and the Weight-bearing Shoulder in the Wheelchair Athlete. Sports Med Arthrosc Rev. 2019 Jun;27(2):42-47. doi: 10.1097/JSA.0000000000000241.

Results Reference

background

PubMed Identifier

20970758

Citation

Jain NB, Higgins LD, Katz JN, Garshick E. Association of shoulder pain with the use of mobility devices in persons with chronic spinal cord injury. PM R. 2010 Oct;2(10):896-900. doi: 10.1016/j.pmrj.2010.05.004.

Results Reference

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PubMed Identifier

14713943

Citation

Samuelsson KA, Tropp H, Gerdle B. Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users. Spinal Cord. 2004 Jan;42(1):41-6. doi: 10.1038/sj.sc.3101490.

Results Reference

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PubMed Identifier

30927682

Citation

Walford SL, Requejo PS, Mulroy SJ, Neptune RR. Predictors of shoulder pain in manual wheelchair users. Clin Biomech (Bristol, Avon). 2019 May;65:1-12. doi: 10.1016/j.clinbiomech.2019.03.003. Epub 2019 Mar 6.

Results Reference

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PubMed Identifier

21971486

Citation

Giner-Pascual M, Alcanyis-Alberola M, Millan Gonzalez L, Aguilar-Rodriguez M, Querol F. Shoulder pain in cases of spinal injury: influence of the position of the wheelchair seat. Int J Rehabil Res. 2011 Dec;34(4):282-9. doi: 10.1097/MRR.0b013e32834a8fd9.

Results Reference

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Citation

Çitaker S, Taşkiran H, Akdur H, Arabaci ÜmÖ, Ekici G. Comparison of the mobilization and proprioceptive neuromuscular facilitation methods in the treatment of shoulder impingement syndrome. Pain Clin. 2005 Jun;17(2):197-202.

Results Reference

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PubMed Identifier

21292803

Citation

Mulroy SJ, Thompson L, Kemp B, Hatchett PP, Newsam CJ, Lupold DG, Haubert LL, Eberly V, Ge TT, Azen SP, Winstein CJ, Gordon J; Physical Therapy Clinical Research Network (PTClinResNet). Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial. Phys Ther. 2011 Mar;91(3):305-24. doi: 10.2522/ptj.20100182. Epub 2011 Feb 3.

Results Reference

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Effects of PNF on Shoulder Pain in Paraplegic Manual Wheel Chair Users

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