Stroke Clinical Trial
Official title:
Passive Range of Motion and Position Training for Stroke Patients With Hemiplegia to Prevent Shoulder Injury or Pain- Ultrasonographic Study
Several factors associated with the hemiplegic shoulder pain after stroke includes rotator cuff injury, bicipital tendonitis, impingement, spasticity, limited external rotation of shoulder joint, adhesive capsulitis, shoulder subluxation, shoulder hand syndrome, and brachial/axillary neuropathy. In this study, the investigators aim to usie high frequency ultrasound to evaluate the relationship between stroke patients with poor shoulder motor function and shoulder tendon injury. Also, assumed that performing passive range of motion and positioning training might prevent tendon injury of shoulder and hemiplegic shoulder pain in either acute or chronic stage of stroke.
Hemiplegic shoulder pain is a common complication. Several factors associated with the
hemiplegic shoulder pain includes rotator cuff injury, bicipital tendonitis, impingement,
spasticity, limited external rotation of shoulder joint, adhesive capsulitis, shoulder
subluxation, shoulder hand syndrome, and brachial/axillary neuropathy. Flaccidity has a
positive association with soft tissue injury or tendon injury of the shoulder.
In the preliminary study, base on the sonography results, it is found that the possibility
of getting tendon injury or inflammation on the affected shoulder joint is higher in the
group of patients who were with worse motor functions during the rehabilitation in hospital.
In this study, one hundred acute stroke patients with hemipelgia will be enrolled. And those
participants would be separated into 2 groups: control group (Brunnstrom stage IV-VI) and
experimental group (Brunnstrom stage I-III). Clinical characteristics and physical findings
will be recorded on the admission date. During the process, the investigators will use high
frequency (5-12 MHz) musculoskeletal ultrasound to evaluate those tendons around bilateral
shoulder joints on the admission date and at 2 weeks later. In the first year after stroke,
half patients in those 2 groups will perform positioning training and passive range of
motion for affected shoulder either during hospitalization or after being discharged. Then,
the investigators will execute physical examination and use high frequency ultrasound to
evaluate those tendons around bilateral shoulder joints of the participants twice after 6
months and 12 months. Then, the investigators will discuss the incidences of shoulder tendon
injury after receiving rehabilitation program according to ultra-sonographic findings.
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