Acupuncture and Trager psychophysical integration in the treatment of wheelchair user's shoulder pain in individuals with spinal cord injury

Dyson-Hudson, T. A.

Shiflett, S. C.

Kirshblum, S. C.

Bowen, J. E.

Druin, E. L.

Archives of physical medicine and rehabilitation

2001

82(8)

1038-1046

RCT

CAM Control

Acu Versus CAM Control

Acupuncture

Ashi Acupuncture Style

Pain

Paralysis

RCT

Restricted Modalities, Acupuncture Only

Semi-Individualized Acupuncture Protocol

Shoulder Pain

Spinal Cord Injuries

Symptom Based Point Selection

TCM Acupuncture Style

Trager Psychophysical Integration

Wounds and Injuries

OBJECTIVE: To determine the effectiveness of acupuncture and Trager Psychophysical Integration (a form of manual therapy) in decreasing chronic shoulder pain in wheelchair users with spinal cord injury (SCI). DESIGN: A prospective clinical trial, with subjects randomized to acupuncture or Trager treatment condition. Subjects served as their own controls by including a 5-week pretreatment baseline period and a 5-week posttreatment follow-up period. SETTING: Rehabilitation hospital research department. PARTICIPANTS: Eighteen subjects with chronic SCI and chronic shoulder pain who used manual wheelchairs as their primary means of mobility. INTERVENTION: Ten acupuncture or 10 Trager treatments over a 5-week period. MAIN OUTCOME MEASURES: Changes in performance-corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI) scores during baseline, treatment, and follow-up periods were assessed by using analysis of variance. RESULTS: The mean PC-WUSPI score +/- standard deviation of the 18 subjects at entry was 48.9 +/- 24.6 (range, 8.0-94). No significant change in mean PC-WUSPI scores occurred during the pretreatment baseline period. Mean PC-WUSPI scores decreased significantly during the treatment period in both the acupuncture (53.4%; 23.3 points) and Trager (53.8%; 21.7 points) treatment groups. The reduced PC-WUSPI scores were maintained in both groups throughout the 5-week posttreatment follow-up period. CONCLUSION: Acupuncture and Trager are both effective treatments for reducing chronic shoulder pain associated with functional activities in persons with SCI

Shoulder Pain

>1/WK

18

5 Weeks