Effects of resistance training on strength, pain and shoulder functionality in paraplegics

Abstract

Study design: Time series design. Objectives: To determine the effects of a shoulder resistance training programme on isokinetic and isometric strength, body composition, pain and functionality in paraplegic subjects. Setting: University of Valencia, Valencia, Spain. Methods: A total of 15 subjects with thoracic spinal cord injury (SCI) performed three testing sessions with an 8-week period between the sessions. Subjects were not disturbed between the first and the second testing sessions. Subjects performed an 8-week resistance training programme after the second testing session. Variations in isometric and isokinetic shoulder muscle strength, body composition, reported pain and shoulder functionality were evaluated. Results: The training programme produced a significant increase (Po0.05) in the isometric and isokinetic strength of several shoulder movements as well as an increase (Po0.05) in arm fat-free mass and a decrease in arm fat mass (FM). Furthermore, reported pain was decreased, (Po0.05) and upper-limb functionality was increased (Po0.05). Conclusion: Implementing resistance training programmes as physical therapy in SCI subjects effectively increases strength, muscle mass and upper-limb functionality, whereas decreasing FM and pain perception.

The Effects of EMG Biofeedback Training on Shoulder Pain and Muscle Tone of Upper Trapezius in Patients with Spinal Cord Injury

“…This results supported the previous research by Ma et al (2011) and by Middaugh et al (2013), which showed the advantages for reducing a pain and decreasing a muscle tone of the neck extensor and the upper trapezius in EMG biofeedback training group as compared with general physiotherapy of pain or active exercise group. In addition, there also demonstrated a significant reduction of pain in exercise group (P<0.001), which is consistent with other previous studies that perform the programs of stretching and strengthening in wheelchair users with a chronic SCI [5][6][7][8][9][10] .…”

“…Exercise programs consisted of both stretching and strengthening exercise. Stretching exercise was applied to the upper trapezius, biceps brachill, pectoralis, and muscles of posterior scapular region, and then strengthening exercises using elastic band focused on the external rotator, shoulder adductor, shoulder extensor, and scapular retractors, which was based on the previous researches 5,[7][8][9] .…”

“…Also, compressive stress such as weight bearing in the acute SCI phase has proven as one of the causes of the shoulder, elbow, wrist, and hand pain 4) . Many previous studies have suggested muscle strengthening and stretching exercises, which reported that muscle imbalance and repetitive use related to self-care and wheelchair were causes of shoulder pain in the SCI patients [5][6][7][8][9][10] . In addition to muscle strengthening and stretching exercises, biofeedback training have offered to control the pain due to overactive muscle 11) .…”

Evaluation of isometric strength in people with spinal cord injury: a review

“…(4,5) Wheelchair users have a higher prevalence of joint diseases due to dependent overuse of the shoulder function to transfer and to drive the wheelchair. (6) These activities have a muscle requirement of about 50% of a repetition maximum (1RM), and these repeated high loads may lead to the development of upper limb pain. (6) During inpatient rehabilitation, the levels of physical activity may improve, however, soon after the exit of such programs these levels tend to decrease.…”

“…(6) These activities have a muscle requirement of about 50% of a repetition maximum (1RM), and these repeated high loads may lead to the development of upper limb pain. (6) During inpatient rehabilitation, the levels of physical activity may improve, however, soon after the exit of such programs these levels tend to decrease. Physical fitness in a person with SCI is usually lower, and impacts on an increased risk of cardiovascular disease; however, for this population it is known that physical activity has a positive effect on health.…”