Key result
A simple exercise program significantly reduced the development of shoulder pain or discomfort at 1 month following cardiac rhythm device implantation compared to standard instructions (4.3% vs 33.3%; P=0.02).
Why the study?
Does a specific exercise protocol prevent shoulder pain and disability in patients undergoing cardiac rhythm management device implantation?
RCT (n=46)
Does a specific exercise protocol prevent shoulder pain and disability in patients undergoing cardiac rhythm management device implantation?
Absolute Event Rate: 4.3% vs 33.3%
p-value: p=0.02
A simple postoperative exercise program significantly reduces the incidence of shoulder pain and impingement following cardiac rhythm management device implantation.
Supports routine post-implantation shoulder exercises; confirms RCT benefit in reducing early pain and impingement.
INTRODUCTION: Shoulder pain and disability ipsilateral to the implant site is a common complication of cardiac rhythm device implantation, yet very little has been published about this morbidity. We designed a study to assess the potential benefit of a simple exercise protocol in preventing shoulder pain postoperatively. METHODS AND RESULTS: Patients undergoing subcutaneous device implantation were randomized to one of two groups. The control group received standard instructions, whereas the exercise group was instructed on specific exercises aimed at strengthening or stretching the shoulder girdle, to be completed 3 days per week. Groups were postoperatively monitored for the development of shoulder discomfort and shoulder impingement by using physical examination and disability questionnaires. At 1 month, seven of 21 control patients reported developing shoulder pain or discomfort compared to one of 23 in the exercise group (P = 0.02). At 6 months, four of 23 control patients still reported worsening shoulder symptoms, compared to none in the exercise group (P = 0.11). In the control group, five of 19 patients developed a positive impingement test at 1 month, versus none in the exercise group (P = 0.01). Scores for the questionnaires designed to assess shoulder pain and dysfunction were worse in the control group. There were no activity-related complications in either group. CONCLUSION: Shoulder pain and disability occurs often following cardiac rhythm management device implantation. A simple exercise program aimed at strengthening the shoulder girdle is effective at preventing this complication.
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Daniels et al. (2011) conducted an RCT in Shoulder pain after cardiac rhythm management device implantation (n=46). Exercise protocol vs. Standard instructions was evaluated on Development of shoulder pain or discomfort at 1 month (p=0.02). A simple exercise program significantly reduced the development of shoulder pain or discomfort at 1 month following cardiac rhythm device implantation compared to standard instructions (4.3% vs 33.3%; P=0.02).
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