All ETDs from UAB

Advisory Committee Chair

C Scott Bickel

Advisory Committee Members

Marcas Bamman

Alan Eberhardt

William Ogard

Laurie Malone

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


Exercise is beneficial to adults with spinal cord injury (SCI) because of its ability to improve function and increase life expectancy. The goal of this dissertation was to determine an effective intervention for increasing aerobic fitness and decreasing shoulder pain in manual wheelchair users with SCI by identifying underlying mechanisms for shoulder pain, optimizing training and utilizing appropriate outcome measures. Three studies were conducted. The first study indicated that exercise interventions for adults with SCI are of low to moderate methodological quality, frequently using outcome measures associated with changes in body structures and functions, and not frequently examining effects on daily activities. The second study indicated that manual wheelchair users with SCI who have subacromial impingement present with similar patterns of scapular instability as able-bodied individuals with impingement, including weakness in the posterior shoulder musculature. The final study indicated that functional electrical stimulation (FES)-assisted rowing is effective to improve aerobic fitness and shoulder pain in manual wheelchair users with SCI. It was concluded that exercise interventions should address outcomes related to daily activities and participation, manual wheelchair users with SCI who have impingement can benefit from able-bodied therapeutic protocols, though emphasis should be placed on increasing posterior shoulder strength, and that FES-assisted rowing is a promising mode of exercise for manual wheelchair users with SCI who have shoulder pain.



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