Shoulder impairment and pain of individuals with newly acquired spinal cord injury compared to uninjured peers

Spinal Cord Series and Cases, 2020 · DOI: 10.1038/s41394-020-0318-1 · Published: July 22, 2020

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

This study compares shoulder health between people who recently experienced a spinal cord injury (SCI) and those without such injuries. It looks at pain, strength, flexibility, and tissue health in the shoulder. The researchers wanted to see if there were any differences in these shoulder measures between the two groups right at the beginning of rehabilitation for the SCI group. They found that people with new SCI reported more shoulder pain and had reduced strength, mobility, and muscle flexibility compared to the uninjured group. However, the actual tissue structure of the shoulder was similar in both groups.

Study Duration

Not specified

Participants

35 individuals with newly acquired SCI and 34 age and gender-matched controls without SCI

Evidence Level

Cohort study

Key Findings

1
Individuals with newly acquired SCI reported greater musculoskeletal shoulder pain compared to controls.
2
Participants with new SCI displayed significantly lower strength across all measures compared to controls.
3
Shoulder mobility was reduced bilaterally in elevation, external rotation and horizontal adduction in individuals with newly acquired SCI.

Research Summary

This study compared musculoskeletal factors in individuals with newly acquired SCI at the rehabilitation initiation to a group of age and gender-matched uninjured individuals. Although the shoulder tissue integrity per the USPRS was not different, those with SCI reported greater musculoskeletal shoulder pain with reduced muscle strength, shoulder mobility and muscle extensibility compared to the control participants. Early identiﬁed clinical impairments associate with progressive impairment and functional loss and further development and persistence of pain. Early awareness and mediation of these clinical impairments may lead to improved long-term outcomes, improving the overall health and well-being of individuals with SCI.

Practical Implications

Early Intervention

Early awareness and modification of clinical impairments may lead to improved long-term outcomes and overall well-being for individuals with newly acquired SCI.

Strength Training

Focus on global shoulder strength during early rehabilitation to mitigate pain development and progression.

Humeral Mobilization

Introduce early and active humeral mobilization in several planes to prevent further functional loss.

Study Limitations

1
The study excluded individuals with higher-level injuries who use power wheelchairs, limiting the generalizability of the results.
2
Information regarding the length of stay in acute care prior to inpatient rehabilitation was not obtained.
3
The musculoskeletal pain description provided by our participants is limited.

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