OPTIMIZING OVERALL FUNCTION OF THE UPPER LIMB IS EFFECTIVE TREATMENT FOR SHOULDER PAIN IN INDIVIDUALS WITH STROKE: A RANDOMIZED CONTROLLED TRIAL

Background: Shoulder pain is frequent after stroke and interferes with the rehabilitative process and functional outcomes. Treatments used for post-stroke shoulder pain are limited and largely ineffective. Objectives: This randomized controlled study was conducted to study the effect of optimizing overall function of upper limb on the basis of pathomechanics and motor relearning as a treatment of hemiparetic shoulder pain. Subjects and methods: Thirty patients with first ever stroke suffering shoulder pain on movement and at rest were included in this study. Pain was measured by the Visual Analogue Scale (VAS) and Chedoke-McMaster Stroke Assessment (CMSA) was used for measuring motor recovery and functional level. Shoulder abduction, flexion and external rotation ranges of motion (ROM) were also measured. The participants were randomly assigned into two equal groups (G1 and G2). Those in G1 received an exercise therapy based on optimizing overall function of upper limb as a treatment of hemiparetic shoulder pain. Shoulder range of motion exercises were done for the patients represented G2. Treatments were applied for twelve weeks 5 times per week for 60 minutes. Results: shoulder pain and motor recovery scores improved significantly in addition to a significant increase in the shoulder ROMs (p < 0.05). Conclusion: These results suggest that exercise therapy which emphasize interrelationship of all areas of the upper limb to optimize overall function exerts positive effects on shoulder pain and functional recovery in participants with stroke.