Arm Crank Ergometry and Shoulder Pain in Persons with Spinal Cord Injury

Abstract 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 (F1,20 =.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.