Innovative rehabilitation for patients after stroke: a common clinical consequence of stroke

Julija Borkytė1, Tomas Būbnelis1, doc. dr. Lina Varžaitytė1, lekt. Joana Kriščiokaitytė1

1Lietuvos sveikatos mokslų universitetas. Medicinos akademija

Background and aim: stroke is the major cause of disability in many developed countries, and hemiple­gic shoulder pain is a common and distressing consequence of stroke. Because shoulder pain impairs the patient’s ability to undertake functional and rehabilitative activities with the affected arm, the condition may undermine the patient’s functional outcome. Post-stroke shoulder pain (PSSP) is a common impairment and occurs in approximately one-third of an unselected stroke population. Although PSSP can improve during rehabilitation, studies have shown that it can be a long-lasting or persistent problem. Patients with more severe paralysis of the arm are increasingly likely to develop shoulder pain.

The aim: the aim  of study was to investigate effectiveness of innovative rehabilitation for patients after stroke.

Methods: totally study consisted of 214 after stroke patients treated in the neurology department of rehabilitation clinic from 2017 – 2018 year. The patients were divided into two groups PSSP and non-PSSP. The data were collected using questionnaire, interviews, medical records before and after patient rehabilitation. Functional independence was measured by Functional Independence Measure (FIM) scale. Patients emotional health was evaluated by SF-36 questionnaire which was adapted for this study. Pain in the shoulder of paralytic arm was evaluated by pain scale from 0 to 10 when 0 – no pain and 10 – unbearable pain. Statistical analysis was performed with SPSS, p<0.05 was significant.

Results: the analysis of pain influence for rehabilitation after stroke shown, that rehabilitation has statistically significant effect for both groups of patients (p<0.001). FIM has been statistically significant higher in non-PSSP group than in PSSP group (57,93±12,73→86,46±16,75 vs 56,84±14,67→ 77,94±13,72). Study has shown that there was no statistically significant difference in improvement of life quality between groups (p<0.001).

Conclusions: shoulder pain is a common consequence of stroke. There are several disorders associated with hemiplegic shoulder pain. Because the management is challenging, preventative measures are of great importance. Treatment strategies vary and should be directed to the underlying pathology.

Rehabilitation has statistically significant effect for patients after stroke with and without PSSP. The analysis has shown statistically significant effect for functional independence for non-PSSP patients group. There was no statistically significant difference between groups for life quality.

Key words: post-stroke shoulder pain, rehabilitation.