Chronic Shoulder Pain Loss

Chronic Shoulder Pain and Its Relationship to Disability in Paraplegic Veterans

Objectives: The purpose of this study is to look at the relationship between chronic shoulder pain and its effects on upper extremity disability and function in VA patients with paraplegic spinal cord injury (SCI), utilizing demographic, anthropomorphic, injury-related, medication and FIM™ instrument data.
Design: A retrospective chart review of data collected during veteran SCI patient’s annual examinations.
Setting: Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin.

Participants: One-hundred randomly selected paraplegic patients who receive care at the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin.
Main
Initial analysis was completed using a simple regression model which showed that chronic shoulder pain was not a statistically significant predictor of decreased FIM™ (p value = 0.18). Higher adjusted body weight was the only statistically significant predictor for shoulder pain (p value = .004). As expected, higher level injuries showed statistically significant decreased FIM™ scores when compared to lower level injuries. Increased age was also associated with a statistically significant decreased in FIM™ scores.
Conclusion: Unlike previous studies, our results show that in the VA population studied, chronic shoulder pain was not a significant predictor of functional limitations. In addition, only higher adjusted body weight was a significant predictor for the presence of shoulder pain. Our study suggests that upper extremity disability and function in the paraplegic spinal cord injury population is multifactorial, and that focusing treatment only on chronic shoulder pain may not significantly improve a patient’s functional
It Measures the level of a patient's disability and indicates how much assistance is required for the individual to carry out activities of daily living. The full FIM instrument is composed of 18 items split into 13 motor tasks and 5 cognitive tasks. In 1996, (Ottenbacher et al) examined the reliability of the FIM using meta-analysis. They found that total FIM had a median interrater reliability value of .95 and median test-retest and equivalence reliability values of .95 and .92, respectively. In our study 8 items of the FIM instrument were used eating, grooming, bathing, upper body dressing, lower body dressing, toileting, toilet transfers, and tub/shower transfers. These ADLs were thought to be the most closely associated with upper extremity function. We called the total additive score of these items the “combined FIM” for our