A programme of static positional stretches does not reduce hemiplegic shoulder pain or maintain shoulder range of motion--a randomized controlled trial.
OBJECTIVE
To evaluate the effectiveness of a programme of static positional stretches and positioning of the stroke-affected shoulder for maintaining shoulder external rotation and decreasing hemiplegic shoulder pain.


METHODS
Randomized controlled trial with pretest and posttest design.


METHODS
Inpatient rehabilitation unit.


METHODS
Thirty-two participants (17 treatment, 15 comparison) with a first time stroke who were admitted for rehabilitation.


METHODS
Treatment participants completed a programme of static positional stretches of the stroke-affected shoulder twice daily and positioned the stroke-affected upper limb in an armrest support at all other times when seated.


METHODS
The main outcome measures were pain-free range of motion into external rotation, pain in the stroke-affected shoulder at rest and with movement, motor recovery and functional independence.


RESULTS
All participants demonstrated a significant loss of external rotation (P = 0.005) with no significant group differences. All participants demonstrated a significant improvement in motor recovery (P < 0.01) and functional independence (P < 0.01) with no significant group differences. There were no significant effects for pain. The comparison group recorded a decrease in mean pain reported with movement from admission to discharge, and the treatment group recorded an increase.


CONCLUSIONS
Participation in the management programme did not result in improved outcomes. The results of this study do not support the application of the programme of static positional stretches to maintain range of motion in the shoulder. The effect of increasing pain for the treatment group requires further investigation.
Gustafsson
Louise
L
Division of Occupational Therapy, University of Queensland, 4072 Brisbane, QLD, Australia. l.gustafsson@uq.edu.au
McKenna
Kryss
K
D000368:Aged; D015444:Exercise; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D016015:Logistic Models; D016059:Range of Motion, Articular; D012047:Rehabilitation Centers; D020069:Shoulder Pain / Q000628:therapy*