2011 Research Poster Abstracts
PREVENTING SHOULDER PAIN AFTER CARDIAC RHYTHM MANAGEMENT DEVICE IMPLANTATION: A RANDOMIZED, CONTROLLED TRIAL
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.