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

Effects of Propioceptive Neuromuscular Facilitation Technique on Shoulder Pain in Paraplegic Manual Wheel Chair Users After Spinal Cord Injury

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.

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.

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:

• 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