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06, 95% CI 5.72-32.40; I  = 65%) (scale 0-15 and physical function (SMD 0.61, 95% CI 0.27-0.94; I  = 0%) were found for active physiotherapy interventions. Only one study included quality of life, making meta-analysis inappropriate. Evidence from a sparse number of studies supports active physiotherapy interventions to decrease shoulder pain and increase physical function in people with SCI who use a manual wheelchair. No studies met the criteria for prevention, highlighting a lack of research investigating prevention of shoulder pain and decrea