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

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 (F_1,20=.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.