Use of potable diagnostic ultrasound to inform treatment choices for hemiplegic shoulder pain following stroke

Kumar, Praveen; Brouwers, Jakko

Abstract

Introduction:
Hemiplegic shoulder pain (HSP) has a reported incidence of up to 84% of patients. The purpose of this case study is to report findings from a patient with HSP who received problem specific treatment and underwent real-time scanning of shoulder region with a portable diagnostic ultrasound. Treatment was modified to address the problems.

Methods/Case Description:
The patient was a 45 year-old woman with right sided-hemiparesis resulting from a clot in December 2013. Patient was undergoing rehabilitation in a private clinic and reported shoulder pain since November 2014. Patient was undergoing rehabilitation (over-arm exercises, electrical stimulation, stretches, Saebo exercises) however, continued to complain of shoulder pain (VAS-7). Ultrasound scanning was undertaken on 23rd February 2015 and following observations were made on both affected (AF) and unaffected (UAF) shoulders. Acromion-greater tuberosity (AGT) distance (AF-3.35 cm, UAF-2.04 cm), diameter of supraspinatus in resting state (AF -1.16 cm, UAF-1.42cm) and contracted state (AF-1.14cm, UAF-1.63cm). Results: Real time US measurement suggested reduction in AGT immediately following treatment. 8 weeks later, VAS score was 3 and patient reported to be able to use arm more for various functional tasks. Diameter of supraspinatus in resting state (AF -1.30 cm, UAF-1.45cm) and contracted state (AF-1.42cm, UAF-1.70cm) suggested some improvement.

Discussion:
This case report demonstrates potential benefits of real-time ultrasound as an assessment tool to inform treatment choices in a chronic patient with stroke.

• Presentation Conference Type: Poster
• Conference Name: Welsh Stroke Conference
• Start Date: Sep 24, 2015
• End Date: Sep 25, 2015
• Acceptance Date: Aug 4, 2015
• Publication Date: Jan 1, 2015
• Publicly Available Date: Jun 6, 2019
• Peer Reviewed: Peer Reviewed
• Keywords: stroke, shoulder pain, diagnostic ultrasound, novel approach, treatment
• Public URL: https://uwe-repository.worktribe.com/output/842819
• Additional Information: Title of Conference or Conference Proceedings : Welsh Stroke Conference