Stroke
Conditions
Keywords
Stroke, Shear wave elastography, Shoulder muscles, Shoulder pain
Brief summary
This study aims 1. To examine the reliability of SWE assessment in the shoulder muscles of persons after a stroke. 2. To assess if differentiation can be made between the hemiplegic (HP) and non-hemiplegic (NHP) side and between stroke patients and matched healthy volunteers (discriminative validity). 3. To assess if an immediate effect on the pectoralis major and minor can be measured after applying transversal stretch technique to the pectoralis major muscles (response validity).
Detailed description
Stroke patients will be assessed on 2 days with an interval of 3 days (Friday - Monday). Day 1 (Friday): shear wave velocity (SWV) will be assessed by 2 assessors in randomised order. Each assessor will evaluate SWV of 6 shoulder muscles (m. supraspinatus, m. infraspinatus, m. rhomboid major, m. deltoideus, m. pectoralis major, m. pectoralis minor). At the end of the assessment secondary outcome measures will be assessed. Day 2 (Monday): SWV will be reassessed by assessor 1 to measure test-retest reliability. Position of the patient will be changed. SWV of the pectoralis major and minor muscle will be reassessed. Assessor 2 will perform a transversal stretch of the m. pectoralis major or a passive mobilisation of the hand at the hemiplegic arm of the stroke patients. Assessor 1 will reassess the SWV of the pectoralis major and minor muscle to assess if there is an immediate effect of the intervention. Assessor 1 will be blinded for the intervention. Healthy controls (matched for age, gender and BMI): Only one test day to assess SWV of 6 shoulder muscles. Secondary outcome measures will be assessed after SWE assessment.
Interventions
PROCEDURESWE assessor 1
SWE for 6 shoulder muscles will be performed. * m. supraspinatus * m. infraspinatus * m. rhomboideus major * m. deltoideus * m. pectoralis major * m. pectoralis minor
PROCEDURESWE assessor 2
SWE for 6 shoulder muscles will be performed. * m. supraspinatus * m. infraspinatus * m. rhomboideus major * m. deltoideus * m. pectoralis major * m. pectoralis minor
PROCEDUREStretch intervention
Transversal stretch of pectoralis major muscle on the hemiplegic side.
PROCEDURENo stretch intervention
Passive mobilisation of the hemiplegic hand.
Sponsors
University Ghent
University Hospital, Ghent
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Stroke group Inclusion: * Stroke patients in the subacute phase after stroke (\< 6 months post stroke) * Able to sit independently with support of the back, but without support of the arms * With upper-limb (UL) impairment: i.e. no maximum score (36) on the shoulder elbow part of the Fugl-Meyer UL (FM UL)
Exclusion criteria
* Other neurologic disorders * Shoulder or neck surgery before stroke onset * Arthroscopic surgery in the last year before stroke onset. * Shoulder or neck pain in the last year before stroke onset. * Severe cognitive or language deficits that inhibit the participants of understanding simple commands or providing valuable information regarding the outcome measures - measured with the Ability Q. * Participants who are not able to maintain the test position. * Pregnancy Healthy controls can participate if they * Have not suffered a stroke or other neurological disorders * Did not have surgery at the shoulder and/or neck * Did not have arthroscopic surgery in the last year before stroke * If they do not suffer any shoulder or neck pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| SWV m. pectoralis minor | Single point of assessment on day 1 (test) | Shear wave velocity of the m. pectoralis minor |
| SWV m. supraspinatus | Single point of assessment on day 1 (test) | Shear wave velocity of the m. supraspinatus |
| SWV m. infraspinatus | Single point of assessment on day 1 (test) | Shear wave velocity of the m. infraspinatus |
| SWV m. rhomboideus major | Single point of assessment on day 1 (test) | Shear wave velocity of the m. rhomboideus major |
| SWV m. deltoideus | Single point of assessment on day 1 (test) | Shear wave velocity of the m. deltoideus |
| SWV m. pectoralis major | Single point of assessment on day 1 (test) | Shear wave velocity of the m. pectoralis major |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Subjective feeling of shoulder stiffness | Assessment day 1 | Question to the patients about how stiff the shoulder feels |
| Sports before stroke | Assessment day 1 | Question if stroke patients performed sports before stroke and which sports they performed before stroke |
| Demographic variables | Baseline assessment day 1 | Age, gender, weight, height, dominance, date of birth, stroke date, type of stroke, side of paresis |
| Passive range of motion of shoulder | Baseline assessment day 1 | Goniometric measurement of shoulder flexion, abduction, external rotation, internal rotation (degrees) |
| Spasticity shoulder muscles | Assessment day 1 | Modified Ashworth Scale (minimum 0 - maximum 4, higher score is more spasticity = worse outcome) of shoulder flexors, extensors, internal rotators, external rotators, adductors, abductors |
| Shoulder subluxation - ultrasound measurement | Assessment day 1 | Acromiohumeral distance of the hemiplegic and non-hemiplegic shoulder subtracted |
| Fugl-Meyer assessment upper limb section | Assessment day 1 | Active recovery of the upper limb motor function |
Other
| Measure | Time frame | Description |
|---|---|---|
| Subcutaneous tissue thickness | Single point of assessment on day 1 | Measurement de thickness of the subcutaneous layer on the ultrasound image of the m. pectoralis major to compare the stroke group and healthy control group. |
Countries
Belgium
Outcome results
None listed