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CompletedNCT04967911Updated Jul 20, 2021

Effects of PNF on Shoulder Pain in Paraplegic Manual Wheel Chair Users

An interventional study of Rhythmic stabilization exercises and conventional treatment in Shoulder Impingement, sponsored by Riphah International University. Completed at 1 site in Pakistan. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2021-07-20.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 7 months after the study started (first participant enrolled Nov 2020, registered Jul 2021).
Phase
Not applicable
Study type
Interventional
Enrollment
22
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

This project was a Randomized control trial conducted to check the Effects of Proprioceptive Neuromuscular Facilitation on Shoulder Pain due to chronic impingement syndrome in paraplegic Manual Wheelchair users after Spinal Cord Injury so that we can have best treatment option for patients with shoulder pain due to manual wheelchair usage. duration was of 6months,convenient sampling was done, subject following eligibility criteria from Spine welfare trust center, Nawaz Sharif social security Hospital were randomly allocated in two groups via lottery method, Group A participants were given baseline treatment along with PNF exercises , Group B participants were given baseline treatment upto 6 weeks and 3 sessions per, post intervention assessment was done after 6 weeks, by self-generated questionnaire (WUSPI) wheel chair users shoulder pain index, (SRQ) Shoulder rating questionnaire and physical assessment by 2 special test was done, data was analyzed by using SPSS version 25.

Read the detailed description

In paraplegic manual wheelchair users Shoulder pain is most common problem after spinal cord injury. Due to wheelchair propulsion, weight relief task and other household activities repetitive load induced on upper limb and put substantial load in particular on shoulder.In spinal cord injured patients shoulder pain is because of over use of upper limb and shoulder during wheelchair related activities and personal care activities. less stability and slight muscle mass leads toward pain in their life at some point because of Muscular imbalance and later on shoulder secondary impingement syndrome. This study compared the rhythmic stabilization technique from PNF exercises with conventional treatment on experimental and control group to see the difference in reduction of pain and disability.

02

Conditions studied

  • Shoulder Impingement

Keywords

  • Spinal cord injury, wheelchair users, Shoulder pain, PNF
03

In context

Shoulder Pain

707 studies on the registry are indexed under Shoulder Pain; 152 are open to participants now.

This study's enrollment of 22 is below the median of 60 across 561 interventional studies indexed under Shoulder Pain.

Browse Shoulder Pain studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,133 studies on the registry; 633 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 18-60 years old paraplegic manual wheel chair users after spinal cord injury.
  • Those having level of injury from C7-T12
  • Patients who are using wheelchair from more than one year.
  • Pain perceived region of one or both Shoulder from last three months or more
  • Pain without radicular symptoms radiating to whole upper limbs.
  • Wheelchair propulsion in activities of daily living,
  • Individuals with positive Neer's test and Hawkins-Kennedy test

Exclusion criteria

Exclusion Criteria:

  • Any red flags (tumor, fracture, metabolic diseases, rheumatoid arthritis, resting blood pressure greater than 140/90 mmHg, prolonged history of steroid use, etc.
  • Any dislocation ,muscular tear and acute problem of shoulder.
  • Presented with a diagnosis of cervical spinal stenosis, exhibited bilateral upper extremity symptoms
  • Any recent surgery of the shoulder
  • Individuals using other mobility devices with wheelchair.
  • Individuals with primary impingement
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
22 participants (actual)

Study arms

  • Experimental
    Rhythmic stabilization exercises

    baseline physical therapy conventional treatment along Rhythmic stabilization exercises

    Other: Rhythmic stabilization exercises

  • Other
    Conventional treatment

    Baseline physical therapy conventional treatment

    Other: conventional treatment

Interventions

  • OtherRhythmic stabilization exercises

    PNF techniques and Conventional Treatment: Experimental group received rhythmical Stabilization Technique on shoulder joint on all shoulder movements up to 1 minute in supine position For stability of joint ,re-establish dynamic rotator cuff stability and to enhance MS strength and decrease pain. Conventional Treatment: heating pad for 15 minutes, TENS (Transcutaneous Electrical Nerve Stimulation) and after that shoulder stretching of upper trapezius muscle, pectorals and levator scapule and isometric exercises of rotator cuff muscles performed in supine .( 10 sec hold and 10 to 15 reps)..

  • Otherconventional treatment

    Conventional Treatment: heating pad for 15 minutes, TENS (Transcutaneous Electrical Nerve Stimulation) and after that shoulder stretching of upper trapezius muscle, pectorals and levator scapule and isometric exercises of rotator cuff muscles performed in supine .( 10 sec hold and 10 to 15 reps)..

06

What researchers measure

Primary outcomes

  1. Wheelchair User's Shoulder Pain Index

    The Wheelchair User's Shoulder Pain Index (WUSPI) was designed to measure shoulder pain in individuals who use wheelchairs. On the visual analog scale from ' 0' to '10 ' estimate level of pain with different activities

    Time frame: 6th Week

Secondary outcomes

  1. Shoulder rating Questionnaire

    Shoulder rating questionnaire (SRQ) was designed to assess the severity of symptoms related to and the functional status of the shoulder. It includes domains of global assessment, pain, daily activities, recreational and athletic activities, work, satisfaction, and areas for improvement. Each domain is graded separately and is weighted to arrive at the total score

    Time frame: 6th Week

07

Study locations

1 site
  • Mansoora hospital, Lahore, Spine welfare centre, Social security hosital
    Lahore, Punjab, Pakistan
08

References and documents

Publications

  • Mason B, Warner M, Briley S, Goosey-Tolfrey V, Vegter R. Managing shoulder pain in manual wheelchair users: a scoping review of conservative treatment interventions. Clin Rehabil. 2020 Jun;34(6):741-753. doi: 10.1177/0269215520917437. Epub 2020 May 12. PubMed 32397819 ↗
  • El Essi K, El-Shafie JM, Al Hawamdah Z, Zaqout SI. Shoulder Pain among Rehabilitated Spinal Cord Injured Persons Using Manually Propelled Wheelchairs in the Gaza Strip: A Survey. Disabil CBR Incl Dev. 2012;23(2):53-71.
  • Soo Hoo J. Shoulder Pain and the Weight-bearing Shoulder in the Wheelchair Athlete. Sports Med Arthrosc Rev. 2019 Jun;27(2):42-47. doi: 10.1097/JSA.0000000000000241. PubMed 31046007 ↗
  • Jain NB, Higgins LD, Katz JN, Garshick E. Association of shoulder pain with the use of mobility devices in persons with chronic spinal cord injury. PM R. 2010 Oct;2(10):896-900. doi: 10.1016/j.pmrj.2010.05.004. PubMed 20970758 ↗
  • Samuelsson KA, Tropp H, Gerdle B. Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users. Spinal Cord. 2004 Jan;42(1):41-6. doi: 10.1038/sj.sc.3101490. PubMed 14713943 ↗
  • Walford SL, Requejo PS, Mulroy SJ, Neptune RR. Predictors of shoulder pain in manual wheelchair users. Clin Biomech (Bristol). 2019 May;65:1-12. doi: 10.1016/j.clinbiomech.2019.03.003. Epub 2019 Mar 6. PubMed 30927682 ↗
  • Giner-Pascual M, Alcanyis-Alberola M, Millan Gonzalez L, Aguilar-Rodriguez M, Querol F. Shoulder pain in cases of spinal injury: influence of the position of the wheelchair seat. Int J Rehabil Res. 2011 Dec;34(4):282-9. doi: 10.1097/MRR.0b013e32834a8fd9. PubMed 21971486 ↗
  • Çitaker S, Taşkiran H, Akdur H, Arabaci ÜmÖ, Ekici G. Comparison of the mobilization and proprioceptive neuromuscular facilitation methods in the treatment of shoulder impingement syndrome. Pain Clin. 2005 Jun;17(2):197-202.
  • Mulroy SJ, Thompson L, Kemp B, Hatchett PP, Newsam CJ, Lupold DG, Haubert LL, Eberly V, Ge TT, Azen SP, Winstein CJ, Gordon J; Physical Therapy Clinical Research Network (PTClinResNet). Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial. Phys Ther. 2011 Mar;91(3):305-24. doi: 10.2522/ptj.20100182. Epub 2011 Feb 3. PubMed 21292803 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 20, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04967911
Lead sponsor
Riphah International University
Responsible party
Sponsor
First posted
Jul 20, 2021
Start date
Nov 30, 2020
Primary completion
May 30, 2021
Completion
Jun 30, 2021
Last update
Jul 20, 2021

Study contacts

Mehwish Ikram, MS
principal investigator · Riphah International University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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