Investigation of the effects of upper extremity and scapular muscle strengthening exercises on head, neck and shoulder posture, functional capacity and fatigue in wheelchair's users.

The aim of this study was to investigate the effects of strengthening exercises of upper extremity and scapular muscle on head, neck and shoulder posture, functional capacity and fatigue in wheelchair's users. The study was conducted in a special physical therapy center in Reyhanlı district of Hatay. The study was conducted on 24 volunteer males between 20 and 35 years of age, with T6-T12 levels of war victim patients with spinal cord injury. The individuals were divided into two groups with simple random methods. The patients in the classic education group (n = 12) received upper extremity strengthening exercises, while the patients in the study group (n = 12) received scapular strengthening exercises in addition to upper extremity strengthenin exercises. Exercises were administered 3 days a week for 4 weeks. At the beginning of the study, the demographic information of the individuals was obtained, and head, neck and shoulder posture measurements, hand grip strength, Wheelchair User's Shoulder Pain Index (WUSPI), and Neck Disability Index (NDI) were evaluated. In addition, fatigue level was assessed by with Fatigue Severity Scale (FSS), functional levels was assessed with Functional Independence Measures (FIM), sleep quality by Pittsburgh Sleep Quality Index (PSQI), depression level was assessed by Beck Depression Inventory (BDI), and quality of life was evaluated according to the World Health Organization Quality of Life Scale (WHOQOL). Evaluations were repeated at the end of 4 weeks of exercise training, and the results were analyzed with the appropriate statistics program. As a result of the evaluations, a significant improvement in neck and shoulder posture, increase in muscle strength, quality of life and decreased in shoulder pain, neck disability and fatigue severity levels were observed in the study group (p<0.05). In addition, functional independence and quality of life scores improved after training (p<0.05). There was no significant difference in sleep quality and depression (p>0.05). As a result, in addition to upper extremity strengthening exercises, scapular muscle strengthening exercises were found to be more effective than single administration of upper extremity strengthening exercises on neck and shoulder posture, muscle strength, shoulder pain, neck disability, fatigue severity, functional independence and quality of life.