Evaluation of a Shoulder Injury Prevention Program in Wheelchair Basketball

in Journal of Sport Rehabilitation
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Context: Previous literature has theorized that alterations in shoulder physical characteristics are present in wheelchair athletes and contribute to shoulder pain and injury. Limited empirical evidence is present that evaluates the effectiveness of a shoulder injury prevention program focusing on improving these altered characteristics. Objective: To evaluate the effectiveness of a 6-week intervention program at improving characteristics that increases the risk of developing pain or shoulder injury. Design: Pretest and posttest. Setting: Home-based and controlled laboratory. Participants: Seven college wheelchair athletes. Interventions: Shoulder range of motion (ROM) and scapular muscle strength were assessed, and a 5-minute injury prevention program was taught to participants. Participants completed the intervention 3 times per week for 6 weeks. Following completion of the program, a postintervention screening was performed. Main Outcome Measures: Internal rotation (IR)/external rotation (ER) ROM, retraction strength, and IR/ER strength. Results: Participants experienced a significant improvement in dominant limb shoulder IR ROM (t6 = 3.56, P = .01) with an average increase of 11.4° of IR ROM and a significant improvement in dominant limb shoulder ER ROM (t6 = 2.79, P = .03) with an average increase of 8.0° of ER ROM. There were no significant increases in shoulder IR or ER strength and scapular retraction strength (P > .05). Conclusions: Improvements in ROM have previously been linked to decreases in shoulder pain and injury in other upper-extremity dominant sports by improving scapular kinematics. These results provide evidence that a 6-week strengthening and stretching intervention program may decrease risk factors for shoulder injury in wheelchair basketball athletes.

Wilroy is with the Department of Physical Medicine & Rehabilitation, Spain Rehabilitation Center, The University of Alabama at Birmingham, Birmingham, AL, USA. Hibberd is with the Department of Health Science, The University of Alabama, Tuscaloosa, AL, USA.

Wilroy (jeremew@lakeshore.org) is corresponding author.
Journal of Sport Rehabilitation
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References
  • 1.

    Doyscher RKraus KFinke BScheibel M. Acute and overuse injuries of the shoulder in sports [in German]. Orthopade. 2014;43:202208. PubMed ID: 24567176 doi:10.1007/s00132-013-2141-x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Burkhart SSMorgan CDKibler WB. The disabled throwing shoulder: spectrum of pathology, part I: pathoanatomy and biomechanics. Arthroscopy. 2003;19:404420. PubMed ID: 12671624 doi:10.1053/jars.2003.50128

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Burkhart SSMorgan CDKibler WB. The disabled throwing shoulder: spectrum of pathology, part II: evaluation and treatment of SLAP lesions in throwers. Arthroscopy. 2003;19:531539. PubMed ID: 12724684 doi:10.1053/jars.2003.50139

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Burkhart SSMorgan CDKibler WB. The disabled throwing shoulder: spectrum of pathology, part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy. 2003;19:641661. PubMed ID: 12861203 doi:10.1016/S0749-8063(03)00389-X

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Gohlke FLippert MJKeck O. Instability and impingement of the shoulder of the high performance athlete in overhead stress [in German]. Sportverletz Sportschaden. 1993;7:115121. PubMed ID: 8273012 doi:10.1055/s-2007-993494

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Jost BZumstein MPfirrmann CWZanetti MGerber C. MRI findings in throwing shoulders: abnormalities in professional handball players. Clin Orthop Relat Res. 2005;434:130137. doi:10.1097/01.blo.0000154009.43568.8d

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Kasten PKopkow CDexel J. Shoulder pain in overhead throwing athlete: an evidence-based training program for treating scapula dyskinesis. Obere Extremität. 2013;8:164169.  doi:10.1007/s11678-012-0199-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Pellegrini APegreffi FPaladini PVerdano MACeccarelli FPorcellini G. Prevalence of shoulder discomfort in paraplegic subjects. Acta Biomed. 2012;83:177182. PubMed ID: 23762992

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Edmonds EWDengerink DD. Common conditions in the overhead athlete. Am Fam Physician. 2014;89:537541. PubMed ID: 24695599

  • 10.

    Blevins FT. Rotator cuff pathology in athletes. Sports Med. 1997;24:205220. PubMed ID: 9327536 doi:10.2165/00007256-199724030-00009

  • 11.

    Spiegl UJWarth RJMillett PJ. Symptomatic internal impingement of the shoulder in overhead athletes. Sports Med Arthrosc. 2014;22:120129. PubMed ID: 24787727 doi:10.1097/JSA.0000000000000017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Budoff JENirschl RPIlahi OARodin DM. Internal impingement in the etiology of rotator cuff tendinosis revisited. Arthroscopy. 2003;19:810814. PubMed ID: 14551541 doi:10.1016/S0749-8063(03)00732-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Ludewig PMCook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther. 2000;80(3):276291. PubMed ID: 10696154

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Kibler WBMcMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11(2):142151. PubMed ID: 12670140 doi:10.5435/00124635-200303000-00008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Lin JJHanten WPOlson SLet al. Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol. 2005;15(6):576586. PubMed ID: 16179197 doi:10.1016/j.jelekin.2005.01.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Peat MGrahame RE. Electromyographic analysis of soft tissue lesions affecting shoulder function. Am J Phys Med. 1977;56(5):223240. PubMed ID: 910880

  • 17.

    Scovazzo MLBrowne APink MJobe FWKerrigan J. The painful shoulder during freestyle swimming. An electromyographic cinematographic analysis of twelve muscles. Am J Sports Med. 1991;19(6):577582. PubMed ID: 1781493 doi:10.1177/036354659101900604

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Cools AMDeclercq GACambier DCMahieu NNWitvrouw EE. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scand J Med Sci Sports. 2007;17(1):2533. PubMed ID: 16774650

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Borich MRBright JMLorello DJCieminski CJBuisman TLudewig PM. Scapular angular positioning at end range internal rotation in cases of glenohumeral internal rotation deficit. J Orthop Sports Phys Ther. 2006;36(12):926934. PubMed ID: 17193870 doi:10.2519/jospt.2006.2241

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Akbar MBalean GBrunner Met al. Prevalence of rotator cuff tear in paraplegic patients compared with controls. J Bone Joint Surg Am. 2010;92:2330. PubMed ID: 20048092 doi:10.2106/JBJS.H.01373

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Kulig KRao SSMulroy SJet al. Shoulder joint kinetics during the push phase of wheelchair propulsion. Clin Orthop Relat Res. 1998;354:132143. PubMed ID: 9755772

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Morrow MMKaufman KRAn KN. Scapula kinematics and associated impingement risk in manual wheelchair users during propulsion and a weight relief lift. Clin Biomech. 2011;26(4):352357. doi:10.1016/j.clinbiomech.2010.12.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Brose SWBoninger MLFullerton Bet al. Shoulder ultrasound abnormalities, physical examination findings, and pain in manual wheelchair users with spinal cord injury. Arch Phys Med Rehabil. 2008;89:20862093. PubMed ID: 18996236 doi:10.1016/j.apmr.2008.05.015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Akbar MBrunner MEwerbeck Vet al. Do overhead sports increase risk for rotator cuff tears in wheelchair users? Arch Phys Med Rehabil. 2015;96(3):484488. PubMed ID: 25449196 doi:10.1016/j.apmr.2014.09.032

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Norkin CCWhite DJ. Measurement of Joint Motion: A Guide to Goniometry. Philadelphia, PA: F.A. Davis; 2009.

  • 26.

    Peterson-Kendall FKendall-McCreary EGeise-Provance PMcIntyre-Rodgers MRomani WA. Muscles Testing and Function With Posture and Pain. Baltimore, MDLippincott Williams & Wilkins; 2005.

    • Search Google Scholar
    • Export Citation
  • 27.

    Kolber MJCleland JA. Strength testing using hand-held dynamometry. Phys Ther Rev. 2005;10(2):99112. doi:10.1179/108331905X55730

  • 28.

    Kluemper MUhl THazelrigg H. Effect of stretching and strengthening shoulder muscles on forward shoulder posture in competitive swimmers. J Sport Rehabil. 2006;15(1):5870. doi:10.1123/jsr.15.1.58

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Boone DCAzen SPLin CMSpence CBaron CLee L. Reliability of goniometric measurements. Phys Ther. 1978;58(11):13551360. doi:10.1093/ptj/58.11.1355

  • 30.

    Kebaetse MMcClure PPratt NA. Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics. Arch Phys Med Rehabil. 1999;80(8):945950. doi:10.1016/S0003-9993(99)90088-6

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Oyama SMyers JBWassinger CALephart SM. Three-dimensional scapular and clavicular kinematics and scapular muscle activity during retraction exercises. J Orthop Sports Phys Ther. 2010;40(3):169179. PubMed ID: 20195020 doi:10.2519/jospt.2010.3018

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Myers JBPasquale MRLaudner KGSell TCBradley JPLephart SM. On-the-field resistance-tubing exercises for throwers: an electromyographic analysis. J Athl Train. 2005;40(1):1522. PubMed ID: 15902319

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Hibberd EEOyama SSpang JTPrentice WMyers JB. Effect of a 6-week strengthening program on shoulder and scapular-stabilizer strength and scapular kinematics in division I collegiate swimmers. J Sport Rehabil. 2012;21(3):253265. doi:10.1123/jsr.21.3.253

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Akbar MBrunner MBalean Get al. A cross-sectional study of demographic and morphologic features of rotator cuff disease in paraplegic patients. J Shoulder Elbow Surg. 2011;20:11081113. PubMed ID: 21724421 doi:10.1016/j.jse.2011.03.021

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Rimmer JHRiley BWang ERauworth AJurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. Am J Prev Med. 2004;26:419425. PubMed ID: 15165658 doi:10.1016/j.amepre.2004.02.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Tawashy AEEng JJLin KHTang PFHung C. Physical activity is related to lower levels of pain, fatigue and depression in individuals with spinal-cord injury: a correlational study. Spinal Cord. 2009;47(4):301306. PubMed ID: 18936771 doi:10.1038/sc.2008.120

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Buchholz AC. Physical activity levels are low in free-living adults with chronic paraplegic. Obesity. 2003;11:563570. doi:10.1038/oby.2003.79

  • 38.

    Crawford AHollingsworth HHMorgan KGray DB. People with mobility impairments: physical activity and quality of participation. Disabil Health J. 2008;1:713. doi:10.1016/j.dhjo.2007.11.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Noreau LShephard RJ. Spinal cord injury, exercise, and quality of life. Sport Med. 1995;20:226250. doi:10.2165/00007256-199520040-00003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Hicks ALMartin Ginis KAPelletier CADitor DSFoulon BWolfe DL. The effects of exercise training on physical capacity, strength, body composition and functional performance among adults with spinal cord injury: a systematic review. Spinal Cord. 2011;49(11):11031127. PubMed ID: 21647163 doi:10.1038/sc.2011.62

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Hirst JPorter H. Obesity management in spinal cord injury through leisure time physical activity. Therap Recreat J. 2015;49(1):7679.

    • Search Google Scholar
    • Export Citation
  • 42.

    Nightingale TEWalhim JThompson DBilzon JL. Predicting physical activity energy expenditure in manual wheelchair users. Med Sci Sports Exerc. 2014;46(9):18491858. PubMed ID: 25134004 doi:10.1249/MSS.0000000000000291

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Tanhoffer RATanhoffer AIRaymond JHills APDavis GM. Exercise, energy expenditure, and body composition in people with spinal cord injury. J Phys Act Health. 2014;11(7):13931400. doi:10.1123/jpah.2012-0149

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Phang SHMartin Ginis KARouthier FLemay V. The role of self-efficacy in the wheelchair skills-physical activity relationship among manual wheelchair users with spinal cord injury. Disabil Rehabil. 2012;34(8):625632. doi:10.3109/09638288.2011.613516

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Norrbrink CLindberg TWahman KBjerkefors A. Effects of an exercise programme on musculoskeletal and neuropathic pain after spinal cord injury-results from a seated double-poling ergometer study. Spinal Cord. 2012;50(6):457461. PubMed ID: 22289901 doi:10.1038/sc.2011.160

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Mulroy SJHatchett PEberly VJHaubert LLConners SRequejo PS. Shoulder strength and physical activity predictors of shoulder pain in people with paraplegia from spinal cord injury: prospective cohort study. Phys Ther. 2015;95(7):10271038. PubMed ID: 25721123 doi:10.2522/ptj.20130606

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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