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2011 Annual Conference

del 27 al 30 de October del 2011

The Woodlands Waterway Marriott

2011 Research Poster Abstracts

PREVENTING SHOULDER PAIN AFTER CARDIAC RHYTHM MANAGEMENT DEVICE IMPLANTATION: A RANDOMIZED, CONTROLLED TRIAL

sábado, el 29 de octubre de 2011 a las 13:00–14:00 CDT
Exhibit Hall
Presenter's Name - Last Name First

Jason Zafereo, PT

Purpose

Shoulder pain and disability ipsilateral to the implant site is a common complication of cardiac rhythm device implantation, yet very little has been published about this morbidity. We designed a study to assess the potential benefit of a simple exercise protocol in preventing shoulder pain postoperatively.

 

Subjects

Patients undergoing subcutaneous device implantation were randomized to one of two groups, a control group (n=29) and an exercise group (n=28). Demographic data for control group: Age 58 years, 16males/13 females, 48% black, 31% white, and 21% hispanic. Demographic data for exercise group: Age 60 years, 19males/9 females, 50% black, 39% white, and 11% hispanic. 

Methods

The control group received standard instructions, whereas the exercise group was instructed on specific exercises aimed at strengthening or stretching the shoulder girdle, to be completed 3 days per week. Groups were postoperatively monitored for the development of shoulder discomfort and shoulder impingement by using physical examination and disability questionnaires.

 

Results

At 1 month, seven of 21 control patients reported developing shoulder pain or discomfort compared to one of 23 in the exercise group (P = 0.02). At 6 months, four of 23 control patients still reported worsening shoulder symptoms, compared to none in the exercise group (P = 0.11). In the control group, five of 19 patients developed a positive impingement test at 1 month, versus none in the exercise group (P = 0.01). Scores for the questionnaires designed to assess shoulder pain and dysfunction were worse in the control group.

 

 

 

Conclusion(s)

Shoulder pain and disability occurs often following cardiac rhythm management device implantation. A simple exercise program aimed at strengthening the shoulder girdle is effective at preventing this complication.

Authors

James Daniels, MD, UT Southwestern Medical Center
Shining Sun, MD, UT Southwestern Medical Center
Owen Obel, MD, UT Southwestern Medical Center
Jason Zafereo, PT, UT Southwestern Medical Center
Abu Minhajuddin, PhD, UT Southwestern Medical Center
Richard Wu, MD, UT Southwestern Medical Center
Jose Joglar, MD, UT Southwestern Medical Center
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