Charotar University of Science and Technology, India
Garima Gedamkar completed her Master of Physiotherapy in Neurology from Swami Vivekanand National Institute of Rehabilitation Training and Research (SVNIRTAR), under Ministry of Social Justice and Empowerment, Govt. of India. She also completed her PG Diploma in Rehabilitation Physiotherapy from All India Institute of Physical Medicine and Rehabilitation (AIIPMR), under Ministry of Health and Family Welfare, Govt. of India. She was honored by All India Institute of Physical Medicine and Rehabilitation, Society for Promotion of Medical Research (Government of India, Ministry of Health and Family Welfare) for outstanding performance. Currently, she is working as a faculty member at Ashok and Rita Patel Institute of Physiotherapy, a constituent of CHARUSAT, India. Apart from being an academician and clinical therapist, she is also involved in community survey and service. [email protected]
30%-50% of the individuals with spinal cord injury (SCI) have shoulder pain of such severity that it interferes with transfers, manual wheelchair propulsion, overhead reaching, and sleep; it can also limit vocational and recreational pursuits. Wheelchair propulsion and transfers (mostly studied) are among the other factors responsible for inducing shoulder pain, which is unavoidable to be functionally independent. In the presence of pain, individuals may not perform up to the optimal level or deny doing exercises. Rest may prolong rehabilitation duration, increase financial burden, depression or reduced motivation. Also, no standardized exercise protocols are available (minimum of 6 weeks and more) due to less number of studies and home exercise programs are of longer duration. 4 weeks (5 days a week, 1 session per day) of cervico-thoracic mobilization when combined with exercises (stretching and strengthening) showed statistically significant decrease in shoulder pain and improved functional independence than exercise therapy alone. Addition of cervico-thoracic mobilization sets platform to perform the exercises optimally, facilitate rehabilitation by immediate pain reduction and maintain the effect 24 hours post-intervention. It also reduces the duration of treatment for shoulder pain as compared to the available protocols. Since level of injury, level of impairment, motivation, environmental factors influence the functional independence, comprehensive approach should be considered.