Hemiplegia, Shoulder Pain, Stroke
Conditions
Brief summary
This is an observational study to address the following questions. 1. How many people develop stroke-shoulder pain within 3 days of stroke? 2. How many people have stroke shoulder pain at 8-10 weeks after stroke? 3. Does having stroke-shoulder pain within 3 days of stroke predict the likelihood of having stroke-shoulder pain at 8-10 weeks? 4. What are the best bedside examination tests to identify stroke-shoulder pain?
Detailed description
Patients will be assessed very early after stroke (within 72 hours) and followed up 8-10 weeks later. Findings will enable planning of fully-powered randomised controlled trials of both, pain-prevention strategies and treatment.
Interventions
OTHERShoulderQ which is a shoulder pain questionnaire
Questions regarding shoulder pain at rest, during movement and at night with visual analogue scales. Factors affecting shoulder pain.
OTHERClinical shoulder examination
Shoulder-Hand-Score (measuring pain, oedema, passive range of movement), muscle strength (using Oxford scale and National Institute of Health Stroke Scale (NIHSS) upper limbe motor and shoulder joint palpation (recording subluxation and soft-tissue pain).
Sponsors
St George's, University of London
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- Clinical diagnosis of haemorrhagic or ischaemic stroke
Exclusion criteria
* Transient Ischaemic attack, * Neurological symptoms due to causes other than acute stroke, * Unconscious, * Severe behavioural disturbance, * Severe agitation, * Severe dementia, * For palliation, * Totally unable to communicate using any method - written, verbal, pictures, gesture
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline severity of hemiplegic shoulder pain at 8-10 weeks | within 72 hours and 8-10 weeks | Questionnaire including visual analogue scales |
| Change from baseline Shoulder-Hand-Score at 8-10 weeks | within 72 hours and 8-10 weeks | Measurement of pain, oedema, passive range of shoulder abduction and passive range of shoulder external rotation |
| Change from baseline NIH Stroke Score Upper limb (Motor Arm) at 8-10 weeks | within 72 hours and 8-10 weeks | Muscle Strength |
| Change from baseline presence/absence of pain on palpation at 8-10 weeks | within 72 hours and 8-10 weeks | Palpation of shoulder joint line and surrounding soft tissues |
| Change from baseline presence/absence of inferior glenohumeral subluxation at 8-10 weeks | within 72 hours and 8-10 weeks | Palpable gap in sub-acromial region with arm dependent |
Countries
United Kingdom
Outcome results
None listed