title: A programme of static positional stretches does not reduce hemiplegic shoulder pain or maintain shoulder range of motion--a randomized controlled trial.
abstract: 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.
authors.affiliation: Division of Occupational Therapy, University of Queensland, 4072 Brisbane, QLD, Australia. l.gustafsson@uq.edu.au
authors.forename: Louise
authors.initials: L
authors.lastname: Gustafsson
authors.forename: Kryss
authors.initials: K
authors.lastname: McKenna
mesh_terms: 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*