Complete shoulder management for Wheelchair users


Shoulder management for wheelchair users from acute care to home program. The following information is provided by Touchstone Rehabilitation, Author Daniel M. Bonaroti, MPT

This booklet will discuss interventions to facilitate a healthy shoulder from the time of injury to post rehabilitation home programs.

Shoulder pain is among the most common sequele of repetitive wheelchair propulsion, transfers and Activities of Daily Living (ADL). Patients with paraplegia experience high frequency of carpel tunnel and shoulder pain. The high risk of shoulder pain is increased in patients with tetraplegia secondary to biomechanical factors and incomplete or absent innervation of the trunk, upper extremity and shoulder stabilizers (rotator cuff, latissimus, pecs). Studies suggest between 50% to 100% of people with Spinal Cord Injurys report shoulder pain. If pain is present, 100% report it affects their ADLs. (1,2,4)

Acute Care

Life saving measures are obviously priority in the acute care setting. However, active therapy involvement at this stage to improve or maintain shoulder range of motion can dramatically impact the success of future shoulder rehabilitation.