Effectiveness of resistance programs in wheelchair users shoulder function: A systematic review

Abstract

Literature presents promising results regarding exercise programs to reduce shoulder pain in manual wheelchair users. However, there is a lack of systematization and specific usefulness of resistance training programs. Thus, the study objective was to analyze the effectiveness of resistance training programs in reducing shoulder pain, and to increase shoulder strength and function in manual wheelchair users (MWUs). A Boolean search strategy adapted for Pubmed, Ebsco, Scopus, Web of Science and Scielo Science databases was undertaken (up to February 2021) to identify all studies measuring changes in shoulder strength, pain, and/or function after implementing a resistance training program in MWUs. Two independent reviewers selected articles based on following criteria: MWUs, participants' age, study design and intervention types. Also, reviewers performed the study quality assessment, risk-of-bias analysis and data extraction. Of the 124 obtained publications, a total of 9 studies met the inclusion criteria, being evaluated through PEDro Scale (mean quality score in four or below) and uncertain risk of bias according to Cochrane Scale assessment. The studies shows that: one-repetition maximum (12-60%), isometric peak force (25-36%) and isokinetic muscle strength (10-30%) increased following resistance training interventions. Significant reductions (22-85%) in shoulder pain (WUSPI score) were found after resistance training interventions. In addition, shoulder function (evaluated by DASH questionnaire) improved (12-60%) following resistance training. The present review highlights the usefulness of resistance training programs to improve muscular strength and shoulder function and to reduce shoulder pain in MWUs. These results have significant practical applications to improve the quality of life of MWUs.