A novel approach using potable diagnostic ultrasound to inform treatment choices for hemiplegic shoulder pain – A case study

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. Patient was undergoing rehabilitation in a private clinic and reported shoulder pain. 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 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). Modified treatment included: 1) Isometric exercises to supraspinatus muscle 2) Trigger point release for trapezius 3) Electrical stimulation to lateral deltoid and supraspinatus 4) avoid over-arm activities
Results: Ultrasound measurement suggested reduction in AGT immediately following treatment. 8 weeks later, VAS score was 3 and patient reported using her 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.
Conclusions: Real-time ultrasound has potential benefits as an assessment tool to inform treatment choices for HSP. Further studies are required in this area.

Citation

Kumar, P., & Brouwers, J. (2016). A novel approach using potable diagnostic ultrasound to inform treatment choices for hemiplegic shoulder pain – A case study. International Journal of Stroke, 11(9 (3S)), https://doi.org/10.1177/1747493016670567

• Journal Article Type: Article
• Acceptance Date: Oct 26, 2016
• Online Publication Date: Oct 26, 2016
• Publication Date: Dec 30, 2016
• Deposit Date: Mar 7, 2017
• Publicly Available Date: Mar 8, 2017
• Journal: International Journal of Stroke
• Print ISSN: 1747-4930
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 9 (3S)
• DOI: https://doi.org/10.1177/1747493016670567
• Keywords: shoulder pain, stroke, diagnostic ultrasound, treatment
• Public URL: https://uwe-repository.worktribe.com/output/904320
• Publisher URL: http://journals.sagepub.com/doi/full/10.1177/1747493016670567