The Effect of Exercise Training for Refugee Wheelchair Users

Abstract

Purpose: The aim of this study was to investigate the effect on head and shoulder posture, pain, neck disability, functional capacity, fatigue, and quality of life of exercise training applied to the upper extremity, scapular, and trunk muscles of refugees using a wheelchair because of spinal cord injury sustained in the Syrian War. Methods: The study included 24 refugees aged 20-35 years who were using a wheelchair. The subjects were randomly separated into 2 groups as the control group (n:12) who received upper extremity strengthening exercises only, and the study group (n:12) who received additional scapular and trunk strengthening exercises. The exercise program was implemented 3 times a week for 4 weeks. Head and shoulder posture angular values were measured with a goniometer. Evaluations were made using the Wheelchair User’s Shoulder Pain Index (WUSPI), Neck Disability Index (NDI), Fatigue Severity Scale (FSS), Functional Independence Measure (FIM), and the World Health Organization Quality of Life short form (WHO-QoL-Bref). Results: Before treatment, the measurements of the groups were homogenous (p>0.05). In the post-treatment evaluations, the shoulder pain, neck disability, and fatigue severity values were significantly lower in the study group (p<0.05). The functional independence and quality of life scores showed a significant improvement in the study group after the training (p<0.05). Conclusion: The study results demonstrated that the addition of scapular and trunk strengthening exercises to upper extremity exercises in the rehabilitation of wheelchair users is more effective in improving head and shoulder posture, neck disability, fatigue severity, functional independence, and quality of life. Variations in the exercise programs given to wheelchair users in refugee camps will contribute to better health outcomes.