Acupuncture and Trager Psychophysical Integration in the treatment of wheelchair user's shoulder pain in individuals with spinal cord injury

Objective: To determine the effectiveness of acupuncture and Trager(R) Psyc hophysical Integration (a form of manual therapy) in decreasing chronic sho ulder pain in wheelchair users with spinal cord injury (SCI). Design: A prospective clinical trial, with subjects randomized to acupunctu re or Tracer treatment condition. Subjects served as their own controls by including a 5-week pretreatment baseline period and a 5-week posttreatment follow-up period. Setting: Rehabilitation hospital research department. Participants: Eighteen subjects with chronic SCI and chronic shoulder pain who used manual wheelchairs as their primary means of mobility. Intervention: Ten acupuncture or 10 Trager treatments over a 5-week period. Main Outcome Measures: Changes in performance-corrected Wheelchair User's S houlder Pain Index (PC-WUSPI) scores during baseline, treatment, and follow -up periods were assessed by using analysis of variance. Results: The mean PC-WUSPI score +/- standard deviation of the 18 subjects at entry was 48.9 +/- 24.6 (range, 8.0-94). No Significant change in mean P C-WUSPI scores occurred during the pretreatment baseline period. Mean PC-WU SPI scores decreased significantly during the treatment period in both the acupuncture (53.4%; 23.3 points) and Trager (53.8%; 21.7 points) treatment groups. The reduced PC-WUSPI scores were maintained in both groups througho ut the 5-week posttreatment follow-up period. Conclusion: Acupuncture and Trager are both effective treatments for reduci ng chronic shoulder pain associated with functional activities in persons w ith SCI.