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Association of Shoulder Problems in Persons With Spinal Cord Injury at Discharge From Inpatient Rehabilitation With Activities and Participation 5 Years Later

Published:September 13, 2015DOI:https://doi.org/10.1016/j.apmr.2015.08.432

      Abstract

      Objective

      To examine whether musculoskeletal shoulder pain and limitations in shoulder range of motion (ROM) at discharge from first rehabilitation are associated with activities and participation restrictions 5 years later in persons with spinal cord injury (SCI).

      Design

      Prospective cohort study.

      Setting

      Eight specialized SCI rehabilitation centers.

      Participants

      Subjects (N=138) with an SCI admitted for first rehabilitation.

      Interventions

      Not applicable.

      Main Outcome Measures

      Peak power output (POpeak), Wheelchair Skills Test (WST), FIM motor score, ability to transfer, Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), mobility range and social behavior subscales of the Sickness Impact Profile 68 (SIPSOC), and employment status.

      Results

      Mean age of the subjects at discharge was 39 years, 72% were men, 32% had tetraplegia, and in 65% the SCI was motor complete. At discharge, 39% reported shoulder pain and 32% had a limited shoulder ROM. In the analyses of variance, shoulder ROM limitation, but not shoulder pain, was associated with all but 1 outcome at 5 years. In the regression analyses, ROM limitations of the shoulder were negatively associated with the ability to transfer (P=.004), FIM motor scores (P<.001), and return to work (P= .027) 5 years after discharge. No significant associations were found with POpeak, WST performance time, SIPSOC, and PASIPD.

      Conclusions

      The presence of limitations in shoulder ROM, but not shoulder pain, at discharge is associated with limitations in activities and employment status 5 years later.

      Keywords

      List of abbreviations:

      PASIPD (Physical Activity Scale for Individuals with Physical Disabilities), POpeak (peak power output), ROM (range of motion), SCI (spinal cord injury), SIP68 (68-Item Sickness Impact Profile), SIPSOC (mobility range and social behavior subscales of the Sickness Impact Profile 68), WST (Wheelchair Skills Test)
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