{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:04:17Z","timestamp":1792695857366,"version":"4.5.0"},"reference-count":72,"publisher":"American Spinal Injury Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"\n Objectives:<\/jats:bold>\n To compare prevalence of shoulder pain (SP) onset over 3 years for individuals with paraplegia from spinal cord injury who participate in one of two shoulder pain prevention program (SPPP) formats with that of a similar population without intervention, and to compare exercise adherence between two SPPP formats.\n Methods:<\/jats:bold>\n The randomized clinical trial (compared to historical controls) included a volunteer sample of 100 individuals without SP at study entry. Eighty-seven participants returned for assessments at 18 and 36 months after study entry. Control group included 220 volunteers from a 3-year observational study with identical inclusion criteria. SPPPs included shoulder home exercises and recommendations to improve mobility techniques that are effective in reducing existing SP in this population. Participants were randomly assigned to receive either one instruction session and a refresher session 4 weeks later with a physical therapist or a 4-week series of 2-hour group classes taught by a physical therapist and peer mentor. Prevalence of SP onset at 18 and 36 months and self-reported average weekly exercise frequency were the main outcome measures.\n Results:<\/jats:bold>\n SP onset was identical in the two SPPPs but was significantly lower at 18 and 36 months in both groups (11% and 24%) compared to controls (27% and 40%,\n p<\/jats:italic>\n < .05). Self-reported average weekly exercise frequency was similar between intervention groups but was significantly lower during the first 4 months in participants who developed SP compared to those without pain (2.12 \u00b1 1.0 vs. 3.01 \u00b1 1.13,\n p<\/jats:italic>\n < .05).\n Conclusion:<\/jats:bold>\n SPPPs reduced SP onset prevalence regardless of instruction format. Exercise adherence was important to the outcome of shoulder pain.\n <\/jats:p>","DOI":"10.46292\/sci20-00013","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T11:51:00Z","timestamp":1624017060000},"page":"40-52","source":"Crossref","is-referenced-by-count":9,"title":["Shoulder Pain Prevention Program for Manual Wheelchair Users With Paraplegia: A Randomized Clinical Trial"],"prefix":"10.46292","volume":"27","author":[{"given":"Lisa Lighthall","family":"Haubert","sequence":"first","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Mulroy","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie J.","family":"Eberly","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnne K.","family":"Gronley","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia E.","family":"Hatchett","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy G.","family":"Conners","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center, Downey, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1082-0744-27-4-40-b1","series-title":"BMJ Clin Evid","first-page":"1","article-title":"Shoulder pain","year":"2010","unstructured":"Murphy\n RJ,\n \n \n Carr\n AJ.\n \n \n Shoulder pain.\n\t\t\t\t\tBMJ Clin 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syndrom: A multidisciplinary review by the Dutch Orthopaedic Assocation","volume":"85","year":"2014","unstructured":"Diercks\n R,\n \n \n Bron\n C,\n \n \n Dorrestijn\n O,\n \n \n .\n\t\t\t\t\tGuideline for diagnosis and treatment of subacromial pain syndrom: A multidisciplinary review by the Dutch Orthopaedic Assocation.\n\t\t\t\t\tActa Orthop.\n\t\t\t\t\t2014;\n\t\t\t\t\t85(\n\t\t\t\t\t3):\n\t\t\t\t\t314\u2013\n\t\t\t\t\t322.\n\t\t\t\t\tdoi:10.3109\/17453674.2014.920991"},{"issue":"6","key":"i1082-0744-27-4-40-b9","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1038\/sj.sc.3100860","article-title":"Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users","volume":"37","year":"1999","unstructured":"Curtis\n KA,\n \n \n Tyner\n TM,\n \n \n Zachary\n L,\n \n \n .\n\t\t\t\t\tEffect of a standard exercise protocol on shoulder pain in long-term wheelchair users.\n\t\t\t\t\tSpinal 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Ther","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.2522\/ptj.20060001","article-title":"Clinical trial of exercise for shoulder pain in chronic spinal injury","volume":"86","year":"2006","unstructured":"Nawoczenski\n DA,\n \n \n Ritter-Soronen\n JM,\n \n \n Wilson\n CM,\n \n \n Howe\n BA,\n \n \n Ludewig\n PM.\n \n \n Clinical trial of exercise for shoulder pain in chronic spinal injury.\n\t\t\t\t\tPhys Ther.\n\t\t\t\t\t2006;\n\t\t\t\t\t86(\n\t\t\t\t\t12):\n\t\t\t\t\t1604\u2013\n\t\t\t\t\t1618.\n\t\t\t\t\tdoi:10.2522\/ptj.20060001"},{"issue":"4","key":"i1082-0744-27-4-40-b12","series-title":"J Neurol Phys Ther","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1097\/NPT.0000000000000103","article-title":"Effectiveness of exercise programs for management of shoulder pain in manual wheelchair users with spinal cord injury","volume":"39","year":"2015","unstructured":"Cratsenberg\n KA,\n \n \n Deitrick\n CE,\n \n \n Harrington\n TK,\n \n \n 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therapy intervention trials","volume":"91","year":"2011","unstructured":"Mulroy\n SJ,\n \n \n Winstein\n CJ,\n \n \n Kulig\n K,\n \n \n .\n\t\t\t\t\tSecondary Mediation and regression analyses of the PTClinResNet Database: Determining causal relationships among the International Classification of Functioning, Disability and Health levels for four physical therapy intervention trials.\n\t\t\t\t\tPhys Ther.\n\t\t\t\t\t2011;\n\t\t\t\t\t91(\n\t\t\t\t\t12):\n\t\t\t\t\t1766\u2013\n\t\t\t\t\t1779.\n\t\t\t\t\tdoi:10.2522\/ptj.20110024"},{"issue":"7","key":"i1082-0744-27-4-40-b16","series-title":"Phys Ther","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.2522\/ptj.20130606","article-title":"Shoulder strength and physical activity predictors of shoulder pain in people with paraplegia from spinal injury: Prospective cohort study","volume":"95","year":"2015","unstructured":"Mulroy\n SJ,\n \n \n Hatchett\n P,\n \n \n Eberly\n VJ,\n \n \n Lighthall Haubert\n L,\n \n \n Conners\n S,\n \n 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Med.\n\t\t\t\t\t2007;\n\t\t\t\t\t30(\n\t\t\t\t\t3):\n\t\t\t\t\t251\u2013\n\t\t\t\t\t255."},{"issue":"3","key":"i1082-0744-27-4-40-b8","series-title":"Acta Orthop","doi-asserted-by":"publisher","first-page":"314","DOI":"10.3109\/17453674.2014.920991","article-title":"Guideline for diagnosis and treatment of subacromial pain syndrom: A multidisciplinary review by the Dutch Orthopaedic Assocation","volume":"85","year":"2014","unstructured":"Diercks\n R,\n \n \n Bron\n C,\n \n \n Dorrestijn\n O,\n \n \n .\n\t\t\t\t\tGuideline for diagnosis and treatment of subacromial pain syndrom: A multidisciplinary review by the Dutch Orthopaedic Assocation.\n\t\t\t\t\tActa Orthop.\n\t\t\t\t\t2014;\n\t\t\t\t\t85(\n\t\t\t\t\t3):\n\t\t\t\t\t314\u2013\n\t\t\t\t\t322.\n\t\t\t\t\tdoi:10.3109\/17453674.2014.920991"},{"issue":"6","key":"i1082-0744-27-4-40-b9","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1038\/sj.sc.3100860","article-title":"Effect of a standard 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torque and manual wheelchair usage for individuals with paraplegia: A preliminary report.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2009;\n\t\t\t\t\t15(\n\t\t\t\t\t2):\n\t\t\t\t\t79\u2013\n\t\t\t\t\t89."},{"issue":"4","key":"i1082-0744-27-4-40-b21","series-title":"Top Spinal Cord Inj Rehabil","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1310\/sci2104-313","article-title":"Relationship between hand contact angle and shoulder loading during manual wheelchair propulsion by individuals with paraplegia","volume":"21","year":"2015","unstructured":"Requejo\n PS,\n \n \n Mulroy\n SJ,\n \n \n Ruparel\n P,\n \n \n .\n\t\t\t\t\tRelationship between hand contact angle and shoulder loading during manual wheelchair propulsion by individuals with paraplegia.\n\t\t\t\t\tTop Spinal Cord Inj 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L,\n \n \n Eberly\n V,\n \n \n Conners\n S.\n \n \n Impact of gender on shoulder torque and manual wheelchair usage for individuals with paraplegia: A preliminary report.\n\t\t\t\t\tTop Spinal Cord Inj Rehabil.\n\t\t\t\t\t2009;\n\t\t\t\t\t15(\n\t\t\t\t\t2).\n\t\t\t\t\tdoi:10.1310\/sci1502-79"},{"key":"i1082-0744-27-4-40-b31","unstructured":"Random number generator. 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