Use of potable diagnostic ultrasound to inform treatment choices for hemiplegic shoulder pain in people with chronic stroke - A case series

Kumar, Praveen; Brouwers, Jakko

Abstract

Background: Hemiplegic shoulder pain (HSP) has a reported incidence of up to 84% of patients. HSP is multi-factorial in nature and interventions are very varied but are generally unsatisfactory. The objective of this case series study is to report findings on patients with HSP who underwent scanning using portable diagnostic ultrasound and received problem specific treatment. Methods: Six patients with HSP were receiving rehabilitation (over-arm exercises, electrical stimulation, stretches, Saebo exercises) in a private clinic but were not showing any improvement. Ultrasound scanning was undertaken and following problems were identified: glenohumeral subluxation (GHS), supraspinatus atrophy (diameter of supraspinatus), rotator cuff tears, and bicipital tendinitis. Treatment included: 1) ultrasound guided electrical stimulation to supraspinatus; lateral deltoid (GHS, supraspinatus atrophy) 2) rotator cuff training / isometric exercises (Rotator cuff tears, supraspinatus atrophy). 3) Avoiding of over-arm activities. Other treatment included scapula setting exercises (for posture and muscle imbalance). Results: At 12 weeks, patients showed 50-75% reduction in pain, 40-60% improvement in GHS (up to 1 cm affected to unaffected difference), increase in diameter of supraspinatus at rest (0.4 cm) and contracted state (0.8cm), increase in range of movement (flexion – 30 degrees, abduction – 45 degrees, external rotation – 40 degrees), improved use of arm for function / rehabilitation, and patients reported improvement in activities of daily living. Clinicians reported improvements in designing and delivery of exercise programme. Conclusion: Portable diagnostic ultrasound has potential to inform treatment choices for HSP and improve patient outcomes

Citation

Kumar, P., & Brouwers, J. (2017, May). Use of potable diagnostic ultrasound to inform treatment choices for hemiplegic shoulder pain in people with chronic stroke - A case series. Poster presented at 2nd Congress on Neurorehabilitation and Neural Repair, Maastricht, The Netherlands

• Presentation Conference Type: Poster
• Conference Name: 2nd Congress on Neurorehabilitation and Neural Repair
• Conference Location: Maastricht, The Netherlands
• Start Date: May 22, 2017
• End Date: May 24, 2017
• Acceptance Date: May 22, 2017
• Peer Reviewed: Not Peer Reviewed
• Keywords: stroke, shoulder pain, diagnostic ultrasound, treatment
• Public URL: https://uwe-repository.worktribe.com/output/887373
• Additional Information: Title of Conference or Conference Proceedings : 2nd Congress on Neurorehabilitation and Neural Repair