A randomized controlled trial of a modified wheelchair arm-support to reduce shoulder pain in stroke patients

Abstract

Objective:To evaluate the effect of modified wheelchair arm-support to mitigate hemiplegic shoulder pain and reduce pain frequency in stroke patients.Design:A single-blind randomized controlled trial using computer-generated simple randomization.Setting:Participants recruited from inpatients at the Guangdong Provincial Hospital of Chinese Medicine.Subjects:A total of 120 patients with stroke were divided into two groups.Interventions:All subjects underwent basic rehabilitation training and wheelchair assistance with eight weeks follow-up period. Patients in the treatment group additionally received modified wheelchair arm-support for at least 60 minutes a day, six days a week, for four weeks.Outcome measures:Primary outcome was measured by the Visual Analogue Pain Scale or Numeric Pain Rating Scale. Secondary outcome was measured using the Upper Extremity Fugl-Meyer Assessment scale, Modified Barthel Index and Quality of Life Index. Measurements were made at 4 weeks and 12 weeks, following the intervention.Results:Patients age from 21 to 83 years (mean ± SD = 62.41 ± 12.26). The average duration of disease was 1.9 ± 1.3 months. At four weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.75 vs. 2, 3.75; P = 0.059). At 12 weeks, the median of pain intensity was higher in the control group (median, interquartile range = 3, 5.00 vs. 0, 1.00; P < 0.001). At 12 weeks, patients with shoulder pain were higher in the control group (6 vs. 1; P < 0.05).Conclusion:Using the modified wheelchair arm-support could lead to the mitigation of hemiplegic shoulder pain and reduction in pain incidence in stroke patients. It may also improve the patients’ quality of life.

Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

“…These include participation based therapy ( 290 – 294 ), quality of life centered care ( 240 , 295 – 310 , 345 ), community based rehabilitation ( 311 – 315 ), home based rehabilitation ( 132 , 193 , 316 – 335 ), self-management ( 336 , 337 ), family or care giver-led training ( 340 – 342 , 350 , 353 , 354 ), telerehabilitation ( 317 , 343 , 346 , 349 ), and early therapy/rehabilitation ( 174 , 338 , 339 , 347 , 348 , 351 , 352 , 355 , 356 ).…”

Incidence, Prevalence, and Risk Factors of Hemiplegic Shoulder Pain: A Systematic Review

“…Hemiplegic shoulder pain (HSP) is a common and disabling complication following a stroke, and it may affect the quality of life [ 1 ]. It often occurs following two to three months of stroke [ 2 , 3 ].…”

“…It often occurs following two to three months of stroke [ 2 , 3 ]. Consequently, HSP may result in withdrawal from rehabilitation programs, longer hospital stays, reduced limb movement, and impaired quality of life [ 1 ]. Numerous causes have been implicated in developing HSP in stroke.…”

The Relationship Between Lifestyle with Chronic Pain and Pain Acceptance in Elderly with Stroke

“…Stroke is followed by different complications, such as reduced physical activity (4), reduced life quality (5), and increasing pain (6). Pain is one of the most important problems in elderly and patients with stroke, which causes a lot of problems for this group of people (7)(8)(9).…”

“…Patients with stroke experience different types of pain, including headaches, shoulder pain, and central post-stroke pins (13). Hemiplegic pain is one of the types of pain in patients with stroke, with an estimated prevalence of 16% to 84% (7,14,15). Also, in the study by Mazzocato et al 69% of patients had pain (16), and in a review article by de Vries et al it was shown that between 87.3% and 87.8% of patients experienced pain, indicating the importance of pain in these patients (17).…”