title: A comparison of the effects of exercise and lifestyle modification on the resolution of overuse symptoms of the shoulder in polio survivors: a preliminary study.
abstract: OBJECTIVE
  To compare the effectiveness of exercise and lifestyle modification therapy in treating shoulder symptoms in polio survivors with lower-extremity weakness.
  
  
  METHODS
  A randomized parallel group study.
  
  
  METHODS
  Research laboratory.
  
  
  METHODS
  Twenty-three subjects recruited from a cohort of 194 polio survivors who had participated in a previous study had bilateral hip-extensor and knee-extensor weakness and reported experiencing shoulder pain on a regular basis with daily activity.
  
  
  METHODS
  Subjects were randomly assigned to 1 of 3 treatment groups. Members of group 1 were placed on a home exercise program that focused on strengthening their hip and knee extensors. Members of group 2 were instructed in lifestyle modification techniques designed to avoid shoulder overuse. Members of group 3 received both interventions.
  
  
  METHODS
  Shoulder symptoms were quantified in terms of number and severity. Isometric strength of bilateral hip and knee extensors was measured with a hand-held dynamometer.
  
  
  RESULTS
  Symptoms improved in all 3 groups. However, members of the exercise-only group (group 1) were the only ones to show a significant difference in both number and severity of symptoms when pre- and posttreatment values were compared.
  
  
  CONCLUSIONS
  Both exercise and lifestyle modification therapies that focus on reducing the stress related to lower-extremity weakness are effective in treating shoulder overuse symptoms in polio survivors. A trend toward greater improvement in shoulder symptoms in subjects who participated in the exercise program and who also showed a trend toward increased knee-extensor strength supports muscle strength and/or endurance as a key factor.
authors: Moss Rehabilitation Research Institute, Philadelphia, PA 19141, USA. mklein@einstein.edu
authors: Mary G
authors: MG
authors: Klein
authors: John
authors: J
authors: Whyte
authors: Albert
authors: A
authors: Esquenazi
authors: Mary Ann
authors: MA
authors: Keenan
authors: Roberta
authors: R
authors: Costello
mesh_terms: D000368:Aged; D012090:Cumulative Trauma Disorders / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D005081:Exercise Therapy; D005260:Female; D006615:Hip / Q000503:physiopathology; D006801:Humans; D007717:Knee / Q000503:physiopathology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D011051:Poliomyelitis / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology*; D016896:Treatment Outcome