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.
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.
- Standard education/exercises for hemiplegic shoulder pain Other
Other Names: Current Standard Treatment Intervention Desc: 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. ARM 1: Kind: Experimental Label: Current Standard Treatment Description: Current standard treatment for hemiplegic shoulder pain will be provided to this group.
- Three dimensional Scapular-Humeral Mobilizations Other
Other Names: Three-Demensional Scapular-Humeral Mobilization Technique; 3-D Scapular-Humeral Mobilizations Intervention Desc: 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. ARM 1: Kind: Experimental Label: Standard treatment + study technique Description: 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.
- Allocation: Randomized
- Masking: Double Blind (Subject, Outcomes Assessor)
- Purpose: Treatment
- Endpoint: Efficacy Study
- Intervention: Parallel Assignment
|Type||Measure||Time Frame||Safety Issue|
|Primary||Measurement of active and passive pain-free shoulder range of motion||1 week prior to intervention||No|
|Secondary||Visual Analogue Scale (used to report the degree of pain experienced during different levels of functional reaching)||1 week prior to intervention||No|
|Secondary||Chedoke McMaster Pain Inventory||1 week prior to intervention||No|