Passive shoulder range of motion impairment in spinal cord injury during and one year after rehabilitation.

Objective: To investigate the prevalence and course of pass notive shoulder range of motion in people with a spinal cord injury and the relationships between shoulder range of motion limitations and personal and lesion characteristics.

Design: Multicentre longitudinal study.

Subjects: A total of 199 subjects with spinal cord injury admitted to specialized rehabilitation centres.

Methods: Assessments of shoulder range of motion at the start of active rehabilitation, 3 months later, at discharge and one year after discharge.

Results: Up to 70% (95% confidence interval (CI): 57-81) of the subjects with tetraplegia and 29% (95% CI: 20-38) of those with paraplegia experienced a limited range of motion of the shoulder during, or in the first year after, inpatient rehabilitation. Shoulder flexion was affected most. Up to 26% (95% CI: 20-37) of subjects had a shoulder range of motion limitation on both sides. Increased age, tetraplegia, spasticity of elbow extensors and longer duration between injury and start of active rehabilitation increased the risk. Presence of shoulder pain is associated with limited shoulder range of motion.

Conclusion: Limited shoulder range of motion is common following spinal cord injury. Tetraplegia, increased age, spasticity of elbow extensors, longer duration between injury and start of active rehabilitation and shoulder pain are associated with an increased risk for shoulder range of motion problems and require extra attention.