Quantifying the Occurrence of Shoulder Pain after Cardiac Surgery in a Cardiac Rehabilitation Population

Abstract

Purpose: The aim of this study was to identify the occurrence of shoulder pain after cardiac surgery among cardiac rehabilitation participants (CRPs) and its interaction with cardiac rehabilitation (CR). Method: This was a cross-sectional questionnaire-based study of open-heart surgery patients conducted at the midpoint of a 6-month CR programme. We measured the proportion of patients experiencing shoulder pain, onset, location, impact on rehabilitation, and pain and disability using the Shoulder Pain and Disability Index. Results: Of 70 (76% men) CRPs, 47% (33) reported shoulder pain post-surgery, with most (91%; 29 of 32) remaining symptomatic at the time of questionnaire completion, 14.6 (SD 37.9) months post-surgery. Disability and pain scores were 4.2 (SD 2.8) and 5.7 (SD 2.5), respectively (maximum score 10). Of people with shoulder pain participating in resistance training (RT; 19), 8 (42%) reported it was beneficial for shoulder pain; 7 (37%), no effect or unknown; and 4 (21%), some aggravation. Modifications to RT by programme staff were reported by 47% (8) of participants. Of those with shoulder pain, 10 (31%) reported some benefit; 20 (63%), no effect or unknown; and 2 (6%), aggravation from aerobic training. Conclusions: Almost half of the CRPs who had undergone open-heart surgery reported moderately severe and disabling shoulder pain that persisted for at least 14.6 (SD 37.9) months. Almost half the RT participants were prescribed exercise modifications with few negative effects. Shoulder pain is a significant issue after surgery, and appropriate screening is recommended for safe CR participation.