Treatment Protocol for Hemiplegic Shoulder Pain

NCT ID: NCT01232218

Last Updated: 2012-07-27

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-10-31
• Study Completion Date: 2012-05-31

Brief Summary

The purpose of this study is to determine if a specific stretching and strengthening protocol, in addition to current standard treatment, is more effective for treating post-stroke shoulder pain than current standard treatment alone.

Detailed Description

Current standard treatment of post-stroke shoulder pain includes joint protection (i.e., slings and protective positioning) and stretching/strengthening exercises through a pain-free range. Although the added movement of the shoulder blade when moving the post-stroke arm has been recommended in the literature, no studies to date have been found which directly looks at the impact of providing synchronized three-dimensional scapular and humeral movement during therapy. Due to the integral relationship between the scapula and the humerus during movement, it is hypothesized that an increase in 3-dimensional shoulder blade mobility in the painful post-stroke shoulder will contribute to increased pain-free 3-dimensional arm movement. This double-blind randomized-controlled study aims to investigate the effectiveness of this 3-D approach at addressing post-stroke shoulder pain.

Conditions

Stroke; Hemiplegia; Shoulder Pain

Keywords

Cerebral Vascular Accident; Stroke; Hemiplegic; Shoulder pain; range of motion; scapula; mobilization

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Current Standard Treatment

Current standard treatment for hemiplegic shoulder pain will be provided to this group.

Group Type: ACTIVE_COMPARATOR

Standard education/exercises for hemiplegic shoulder pain

Intervention Type: OTHER

Each participant will receive standard education for safe positioning and movement of the painful hemiplegic shoulder. Participants will also be provided with standard stretching and strengthening exercises by and experienced Occupational Therapist who will grade the level of exercise to suit their needs. Intervention will take place 3x/week for 1 hour.

Standard treatment + study technique

Participants will receive current standard treatment for hemiplegic shoulder pain PLUS an additional stretching/strengthening technique. Both groups will be allotted the same treatment time.

Group Type: EXPERIMENTAL

Three dimensional Scapular-Humeral Mobilizations

Intervention Type: OTHER

Each participant will receive standard education for safe positioning and movement of the painful hemiplegic shoulder. Participants will also be provided with stretching and strengthening exercises by and experienced Occupational Therapist who will grade the level of exercise to suit their needs. Intervention will take place 3x/week for 1 hour. Participants in this group will receive an additional scapular humeral mobilization while simultaneously performing the standard stretching/strengthening exercise protocol.

Interventions

Standard education/exercises for hemiplegic shoulder pain

Each participant will receive standard education for safe positioning and movement of the painful hemiplegic shoulder. Participants will also be provided with standard stretching and strengthening exercises by and experienced Occupational Therapist who will grade the level of exercise to suit their needs. Intervention will take place 3x/week for 1 hour.

Intervention Type: OTHER

Three dimensional Scapular-Humeral Mobilizations

Each participant will receive standard education for safe positioning and movement of the painful hemiplegic shoulder. Participants will also be provided with stretching and strengthening exercises by and experienced Occupational Therapist who will grade the level of exercise to suit their needs. Intervention will take place 3x/week for 1 hour. Participants in this group will receive an additional scapular humeral mobilization while simultaneously performing the standard stretching/strengthening exercise protocol.

Intervention Type: OTHER

Other Intervention Names

Current Standard Treatment; Three-Demensional Scapular-Humeral Mobilization Technique; 3-D Scapular-Humeral Mobilizations

Eligibility Criteria

Inclusion Criteria

• diagnosis of shoulder pain secondary to altered alignment and/or neuro-muscular movement patterns post-stroke;
• medically stable and 2-24 months post onset of stroke;
• between stages of 2-5 of the Chedoke-McMaster stages of upper extremity motor recovery;
• not currently receiving any other active neuro-rehabilitation intervention to promote stroke recovery;
• cognitively able to provide informed consent, follow specific testing commands, and communicate their level of pain during assessment and treatment.

Exclusion Criteria

• a history of shoulder pain prior to the onset of the stroke;
• shoulder pain which is secondary to any history of trauma, fractures, arthritis or joint instability of the neck, spine, ribs, or shoulder girdle before or after the stroke; possible rotator cuff tears;
• shoulder-hand syndrome; thalamic or central pain; spinal cord pathology; osteoporosis;
• any medical condition which may affect the ability to participate in an active rehabilitation exercise program (i.e., uncontrolled hypertension or angina).

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Toronto

OTHER

Sponsor Role: collaborator

Connect Learning Centre

UNKNOWN

Sponsor Role: collaborator

Ontario Stroke Network

OTHER

Sponsor Role: collaborator

Toronto Rehabilitation Institute

OTHER

Sponsor Role: lead

Responsible Party

Denyse Richardson

Dr. Denyse Richardson

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Denyse Richardson, MD; M.Ed

Role: PRINCIPAL_INVESTIGATOR

Toronto Rehabilitation Institute

Locations

Toronto Rehabilitation Institute

Toronto, Ontario, Canada

Countries

Canada

Other Identifiers

DRLP-10-010

Identifier Type: -

Identifier Source: org_study_id