Management of hemiplegic shoulder pain: A UK-wide online survey of physiotherapy and occupational therapy practice

Kumar, Praveen; Turton, Ailie; Cramp, Mary; Smith, Mark; McCabe, Candy

Abstract

Purpose: The purpose of this study was to explore, via an online survey, how therapists assess, diagnose and manage hemiplegic shoulder pain (HSP) in the United Kingdom. The objectives were to explore (1) how therapists assessed HSP, (2) what the aims of therapy were, (3) what interventions therapists used, (4) what outcome measures therapists used, (5) what training of HSP therapists had, and (6) what barriers therapists experienced in the management of HSP. Methods: An online survey was distributed to physiotherapists (PTs) and occupational therapists (OTs) working in stroke rehabilitation via professional bodies' interest groups. Results: Sixty-seven responses were received: 40 (60%) were PTs and 27 (40%) were OTs. Therapists routinely screened for HSP (n = 59, 89%). When HSP was assessed, 33 (50%) spent 10 min on assessment. Patient-reported pain was used for assessment of HSP by 66 (99%) of respondents. Frequent interventions included positioning (n = 62, 94%), posture re-education (n = 57, 86%), and range of motion exercises (n = 55, 83%). Range of movement was used as an outcome measure by 31 (47%). Sixty (91%) respondents reported receiving training in HSP management. Time constraints (n = 41, 62%) and lack of diagnosis of HSP (n = 33, 54%) were identified as barriers to providing appropriate care to people with HSP. Conclusion: Study findings showed varied practice in the assessment and treatment for HSP and indicate that time constraints are a considerable barrier to the management of these patients. Further research is required to establish best practice which may help improve outcomes and care for people with poststroke shoulder pain.

• Journal Article Type: Article
• Acceptance Date: Jul 24, 2020
• Online Publication Date: Aug 15, 2020
• Publication Date: Jan 1, 2021
• Deposit Date: Aug 20, 2020
• Publicly Available Date: Aug 21, 2020
• Journal: Physiotherapy Research International
• Print ISSN: 1358-2267
• Electronic ISSN: 1471-2865
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 26
• Issue: 1
• Article Number: e1874
• DOI: https://doi.org/10.1002/pri.1874
• Keywords: Physical therapy, sports therapy and rehabilitation, assessment diagnosis, hemiplegic shoulder pain, management, stroke
• Public URL: https://uwe-repository.worktribe.com/output/6594652
• Publisher URL: https://doi.org/10.1002/pri.1874
• Additional Information: Received: 2020-02-03; Accepted: 2020-07-24; Published: 2020-08-15