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Purpose: To analyze the eectiveness of a 6-month exercise protocol on shoulder pain experienced by wheelchair users during functional activities. Subjects: Forty-two wheelchair users, 35 males and seven females: average age of 35 years and an average duration of wheelchair use of 14 years. Methods: Subjects were randomly assigned to treatment (n=21) and control (n=21) groups.The treatment group received instruction in ®ve shoulder exercises which they performed daily for 6 months. The exercise protocol included two exercises for stretching anterior shoulder musculature and three exercises for strengthening posterior shoulder musculature. Outcome measures: All subjects completed a self-report questionnaire and the Wheelchair Users Shoulder Pain Index (WUSPI) initially and at bimonthly intervals during the 6-month intervention. Results: Seventy-®ve per cent of the subjects reported a history of shoulder pain since beginning wheelchair use. The average initial performance-corrected (PC-WUSPI) score of the 42 subjects was 17.7 (+21.3) with a range of 0 ± 103.2 points. Over 83% of the subjects (35 of 42) completed the 6-month study. Subjects in the treatment group decreased their PC-WUSPI score by an average of 39.9%, compared to decreases of only 2.5% in the control group. Conclusions: These ®ndings supported the eectiveness of this exercise protocol in decreasing the intensity of shoulder pain which interferes with functional activity in wheelchair users.

The purpose of this investigation was to document the degree of weakness present in the medial and lateral muscle groups of individuals with chronically unstable ankles. Peak isometric and isokinetic torque measurements were collected bilaterally during the motion of inversion-eversion from 33 subjects, ages 17 to 54, reporting unilateral chronic lateral instability. Values were then compared between the involved and uninvolved sides. A modified Romberg test was also performed bilaterally to determine gross balance differences between the involved and uninvolved lower extremities. No significant difference in muscle strength was documented either isometrically or isokinetically, but balance differences were found between the two extremities in a majority of subjects. The findings suggest that muscular weakness is not a major contributing factor to the chronically unstable ankle. The findings do support the presence of proprioceptive deficits associated with this condition. Based on the results, proprioceptive activities should be a primary consideration in management of the chronically unstable ankle.

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The purpose of this study was to determine the intrarater and interrater reliability of mean peak torque values for the reciprocal motions of plantarflexion/dorsiflexion (PF/DF) and inversion/eversion (INV/EVER), generated isokinetically at 60 and 1 20°/ sec. Forty-one healthy subjects, ranging in age from 20-75, were tested on three different occasions. The three test sessions were performed at the same time of day and separated by at least 24 hours. Pearson product-moment correlations were used to determine reliability for all ankle motions tested. lntrarater reliability of peak torque values for PF/DF and INV/EVER at both speeds ranged from 0.78-0.94, while the range of interrater coefficients was from 0.82-0.94. The results of this study suggest that when using a well defined clinical protocol, acceptable reliability for both testretest and interrater situations can be obtained for isokinetic peak torque values of the ankle musculature at low and relatively high test speeds.