ISS 2017 Program


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PC04: Shoulder Evaluation: An Evidence-Based Approach for Clinicians

Shoulder pain following SCI in recent studies has found the incidence as high as eighty percent. Given the high evidence of shoulder pain in SCI and the overuse of the shoulder with any manual wheelchair user, clinicians are frequently called upon to evaluate and establish treatment programs for these individuals. What evidence are clinicians using to evaluate the shoulder complex? What types of interventions have been supported in literature and in clinical practice?

The overall goal of this course is to provide PT's, OT's, TR's, ATP's a foundation of "neuro-orthopedic" based evaluation techniques and principles for the shoulder complex to implement into practice. The course will give hands on demonstration of specific assessment tools, outcome measures and lab to practice these techniques from a Physical Medicine and Rehabilitation Physician, Occupational Therapist, Physical Therapist, and Rehab Engineer perpective.

We will utilize the most current evidence to establish: a more comprehensive understanding of glenohumeral joint and scapulo-thoracic biomechanics as it relates to pathology of the shoulder in individuals with spinal cord injury, enhance examination techniques to correctly identify shoulder pathology, design algorithms to rule out other possible causes of shoulder pain, and provide attendees with effective strategies to incorporate into their practice for guiding the wheelchair selection process.

By clinicians applying and integrating a comprehensive orthopedic approach into treatment planning and seating recommendations, wheelchair users will be given the opportunity to reduce the incidence of shoulder pain and UE impairments.


Learning Objectives:



Wendy Koesters, PT, ATP/SMS
Columbus, Ohio
United States

Wendy Koesters is a Physical Therapist at The Ohio State University Wexner Medical Center with a focus on seating and mobility. She shares her time with the out-patient rehab center treating both orthopedic and neurologic clients. Wendy has presented at prior International Seating Symposiums, and local Adapted Sport Conference. She has a special interest in shoulder preservation and treatment to positively impact daily life and participation in adapted sports and wellness for wheelchair users.

Martin J Kilbane, PT, DPT, OCS
Cleveland VA Medical Center
United States

Marty Kilbane is the Supervisor of Rehabilitation Therapies for the Cleveland VA regional spinal cord injury center. He is a Physical Therapist and Board Certified Clinical Specialist in Orthopedics. Marty has presented over 80 formal lectures on a variety of topics with the focus of utilizing current evidenced based practice and research to improve clinical outcomes. Over the past decade, he has concentrated his efforts into improving the clinical understanding, diagnosis, and treatment of shoulder pathology as it pertains to individuals with spinal cord injury and wheeled mobility users.

Daniel Kim, MD
Ohio State Wexner Medical Center
Columbus, OH
United States

Dr. Kim is a board certified PM&R physician and Medical Director of the Wheelchair Seating and Positioning clinic at The Ohio State University Wexner Medical Center. He works closely with a core group of Physical and Occupational Therapists to ensure that his patients receive medically appropriate and optimally configured mobility equipment. Dr. Kim also has an interest in spinal cord injury rehabilitation and facilitating promoting participation in adaptive sports.

Theresa F. Berner, MOT, OTR/L, ATP
Wexner Medical Center At The Ohio State University
Columbus, Ohio
United States

Theresa Berner, MOT, OTR/L, ATP is an OT and Rehabilitation Clinical Manger at The Ohio State University Medical Center. She has over 23 years' experience in seating and positioning. Theresa has been certified by RESNA as an Assistive Technology Professional (ATP). She is responsible for Assistive Technology center and is a clinical instructor at the School of Health and Rehabilitation Sciences at OSU .Theresa has participated in presentations across the country at many conferences

Carmen P Digiovine, PhD, ATP/SMS, RET
The Ohio State University
Columbus, Ohio
United States

Carmen P. DiGiovine is a Rehabilitation Engineer and is currently a Clinical Associate Professor in the Occupational Therapy Division and the Biomedical Engineering Department at The Ohio State University. He is also the Director of Rehabilitation Science and Technology for the Assistive Technology Center at The Ohio State University Wexner Medical Center. He has presented at national and international conferences for the past 20 years, and regularly teaches a courses at The Ohio State University.



    1. Ludewig, P., & Cook, T. (2000). Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical Therapy. 80(3), 276-91.
    2. Sasso, E., & Backus, D. (2013). Home-based circuit Resistance Training to overcome barriers to exercise for people with spinal cord injury: a case study. JNPT. 37, 65-71.
    3. Mulroy, S. J., Thompson, L., Kemp, B., Hatchett, P. P., Newsam, C. J., Lupold, D. G., . . . Gordon, J. (2011). Strengthening and Optimal Movements for Painful Shoulders (STOMPS) in Chronic Spinal Cord Injury: A Randomized Controlled Trial. Physical Therapy, 91(3), 305-324.
    4. Cratsenberg, K. A., Deitrick, C. E., Harrington, T. K., Kopecky, N. R., Matthews, B. D., Ott, L. M., & Coeytaux, R. R. (2015). Effectiveness of Exercise Programs for Management of Shoulder Pain in Manual Wheelchair Users With Spinal Cord Injury. Journal of Neurologic Physical Therapy, 39(4), 197-203.
    5. Straaten, M. G., Cloud, B. A., Morrow, M. M., Ludewig, P. M., & Zhao, K. D. (2014). Effectiveness of Home Exercise on Pain, Function, and Strength of Manual Wheelchair Users With Spinal Cord Injury: A High-Dose Shoulder Program With Telerehabilitation. Archives of Physical Medicine and Rehabilitation, 95(10).
    6. Merolla, G. (2014). Assessment of the ability of wheelchair subjects with spinal cord injury to perform a specific protocol of shoulder training: A pilot study. MLTJ Muscles, Ligaments and Tendons Journal.

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Updated | 01.17.2016      Facebook logo  Twitter
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