Characteristics of the shoulder in patients following acute stroke: a case series. Issue 4 (19th May 2019)

• Record Type: Journal Article
• Authors: Gaitan, Melissa; Bainbridge, Liz; Parkinson, Stephanie; Cormack, Leanne; Cleary, Sarah; Harrold, Meg
• Is Part Of: Topics in stroke rehabilitation. Volume 26:Issue 4(2019)
• Page Start: 318
• Page End: 325
• Publication Date: 2019-05-19
• Subjects: Stroke -- hemiplegia -- shoulder pain -- shoulder joint -- range of motion -- movement -- stroke rehabilitation; Cerebrovascular disease -- Patients -- Rehabilitation -- Periodicals; Cerebrovascular disease -- Periodicals; 616.810305
• DOI: 10.1080/10749357.2019.1590973
• Languages: English
• ISSNs: 1074-9357

Abstract

ABSTRACT: Background : Stroke can result in pain and loss of motor control in the hemiplegic shoulder, and while prevention of secondary changes is likely to be the most effective management, there is limited evidence directing clinicians towards the most at-risk patients. Objectives : The aim of this case series was to investigate the presentation of shoulder pain, motor impairment, shoulder passive range of motion (PROM) and alignment of the hemiplegic shoulder following acute stroke. Methods : This study reported data that was collected as part of a pilot randomized controlled trial investigating kinesiology taping of the hemiplegic shoulder. Participants with a diagnosis of acute stroke and severe upper limb motor impairment were included. From 24-h post stroke and continuing every three days until discharge, measurements of shoulder pain (visual analogue scale, Ritchie Articular Index), motor impairment (Chedoke McMaster Stroke Assessment), PROM and alignment (both clinical measures) were collected. Clinical trial registry number – ACTRN12615000502538. Results : Of 156 patients screened over six months, 10 of 15 eligible participants were recruited. On initial assessment, three participants reported pain and all had severe upper limb motor impairment. All participants initially demonstrated close to full shoulder PROM. Six participants had shoulder subluxation and five demonstrated scapula malalignment. Conclusions : Given the severity of upper limb motor impairment, pain and reduced PROM were seen in a small number of participants. The clinical course of shoulder pain and PROM following stroke remains unclear. Large observational studies tracking shoulder characteristics from acute through to rehabilitation settings are needed.