STOMPS

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STOMPS
Strengthening and Optimal Movements for Painful
Shoulders in chronic spinal cord injury

• Progress Report 2005

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STOMPS
Principal Investigators Bryan Kemp PhD Sara
Mulroy PhD, PT Robert Waters MD
Project Manager Dee Gutierrez PT
Intervention Therapist Craig Newsam DPT
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Purpose
To investigate the effectiveness of a treatment
program combining shoulder exercises with
optimization of movement performance on shoulder
pain, quality of life, and physical function.
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Population

• Paraplegia resulting from SCI
• Push a manual wheelchair 50 time
• Experiencing shoulder pain in one or both
  shoulders
• Do not have a complete tear

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Design
Recruitment
Screening
Pre-assessment
Exercise
Education
Post assessment
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Recruitment Status

• 2 screened/week 5 enrolled/month

66
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Current Status

• LBMMC
• Abilities Expo
• Rancho

Recruitment
Screening
66
Pre-assessment
Exercise
Education
28
25
Post assessment
POST 1 30 POST 2 24
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Current Status

• Of the 66 enrolled participants
• Total attrition, n13 (20)
• 30 completed Post 1 (17EX,13C)
• 18 participants are on-program
• 5 participants outstanding
• 24 completed Post 2

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Dissemination Efforts
Presentations
Professional organizations CSM, CC-APTA,
ASIA Hospitals St. Jude, Rancho, LB Memorial
Upcoming scheduled events LB VA June 17 SCI
continuing ed June 29 Monthly educational
seminar
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Future Dissemination
Outcome Papers
PRIMARY Effect of Exercise on Shoulder Pain in
Persons with SCI Exercise versus education
WUSPI SF-36
SECONDARY PASIPD, Shoulder Torque, Propulsion
Speed
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Dissemination Efforts
Manuscripts in Preparation
Intervention Standardized Individualized
Exercise Program
Effect of Shoulder Pain WUSPI and SF-36, SQoL,
CA
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Stretching Program
Anterior Thoracic
Upper Trapezius
Posterior Capsule
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Strengthening Program
Scaption
External Rotation
Pull Down
Retraction
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Intervention Protocol

• Standardized
• Content
• Relative exercise intensity
• Individualized
• Exercise modification if needed for balance,
  elbow wrist pain
• Method of transfer / WC propulsion style

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Exercise Adherence

• 17 subjects have completed the 12-week
  intervention program
• Average frequency of exercise reported as 2.7
  times per week via the exercise diaries
• 6 month follow-up survey by mail (n15)
• 100 of respondents in intervention group
  continue exercise

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Movement Optimization Program

• Transfers Raises
• 10 STOMPS recommendations
• 8 included in PVA Consortium Guidelines
• Panel Opinion STRONG
• Wheelchair Propulsion
• 9 STOMPS recommendations
• 3 included in PVA Consortium Guidelines
• Panel Opinion STRONG

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Shoulder Pain

• The effect of shoulder pain (WUSPI) on
• SF-36, physical function items
• Community Activities
• Subjective Quality of Life Scale

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Shoulder Pain Upper Limb Function
r -0.403 p0.007
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Shoulder Pain Community Activities
r -0.141 p0.360
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Shoulder Pain Community Activities
r -0.441 p0.003
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Shoulder Pain Quality of Life
r -0.428 p0.005
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Shoulder Pain and SCI
Intervention ? shoulder pain resulting in ?
upper limb function ? community activity ?
quality of life
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STOMPS

• Thank you