EFFECTIVENESS OF REHABILITATION AND PHYSICAL THERAPY PROGRAM FOR POST-STROKE SHOULDER PAIN SYNDROME
DOI:
https://doi.org/10.32782/2522-1795.2025.19.1.9Keywords:
acute cerebrovascular accident, stroke, physical therapy, shoulder joint, rehabilitation, poststroke shoulder pain syndrome, rehabilitation programAbstract
Objective. Optimization of physical therapy tactics for patients with post-stroke pain syndrome in the shoulder area. Materials and methods. The study was conducted among 111 patients with the consequences of acute cerebrovascular accidents who have post-stroke pain syndrome in the shoulder. The main group included 68 people. The control group included 43 patients. All patients underwent clinical and special research methods (intensity of pain syndrome using the VAS scale; MAS spasticity scale, Barthel and Rankin scales; assessment of functional activity of the hand was carried out according to the Frenchay Arm Test, and assessment of basic motor skills was carried out using the Chedoke McMaster Stroke Assessmen examination method. Results of the study. With a mild degree of pain syndrome, patients most often have a stroke severity score of 0–7 points – in 54,7% of cases (P < 0,001) compared to the other two degrees. With a moderate degree of pain syndrome, patients with a stroke severity score of 8–14 points were more often found, which is observed in 45,3% of cases (Р = 0,035 when compared with the subgroup “0–7 points”). According to the Barthel scale, only 21,9% had a reduced degree of independence in everyday life (P < 0,05 compared to the other two subgroups). With mild severity of pain syndrome, the degree of depression, expressed in points of the HADS anxiety and depression scale, was 14,1 ± 2,2 points, with moderate – 18,9 ± 1,1, with severe – 27,8 ± 3,2 points. Conclusions. Shoulder pain syndrome occurs in 12,5% of cases according to the VAS scale. A rehabilitation treatment program has been developed, which includes: correction of the bone-articular and muscle component of the shoulder girdle and upper limb; management of motor control from the central nervous system; formation of the ability to act with hands (restoration of motor forms of life); correction of the patient’s psychological state; if necessary, leveling the pain syndrome. In the acute and early post-stroke periods with the appearance of mild shoulder pain, physical exercises (PE) + acupressure (TM) + kinesiotherapy (KT) + physiotherapy procedures (FTP) are recommended; for moderate pain syndrome: PE + TM + CT; for severe pain syndrome: PE + TM + CT + FTP + psychological correction (PC).
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