Bobath Approach On Hemiplegic Shoulder Pain

Istanbul Arel University30 enrolled

Overview

In this study, it is investigated that whether Bobath approach is superior to conventional physiotherapy in terms of improving hemiplegic shoulder pain, spasticity and upper extremity functionality in stroke patients.

Objective: This study aims to determine the effect of Bobath approach on hemiplegic shoulder pain, spasticity and upper extremity functionality in stroke patients. Patients and Methods: For this prospective, randomized, controlled and single-blind trial, 30 stroke patients aged 40-65 years with hemiplegic shoulder pain were included. Patients were divided into two groups and randomized into these groups. Only conventional physiotherapy was applied to the control group, whereas both conventional physiotherapy and Bobath exercises were also applied to the experimental group. Visual analog scale (horizontal) for shoulder pain, modified Ashworth scale for spasticity and Fugl-Meyer assessment of the upper extremity for functionality were used for both pre-test and post-test.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Hemiplegic Shoulder Pain

Interventions

Bobath treatment approachPROCEDURE

scapulothoracic mobilization exercise, reaching in different directions in the supine position and upper extremity weight transfer exercise.

Conventional physiotherapyPROCEDURE

range of motion, stretching, strengthening exercises, electrotherapy, thermotherapy, balance and mobility exercises and exercises for daily living activities.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients between the ages of 40 and 65 * Patients who had a stroke for the first time and had a disease duration of at least four weeks * Patients who were diagnosed with ischemic or hemorrhagic stroke * Patients who had Brunnstrom stage 3, 4 or 5 and had hemiplegic shoulder pain were included in the study. Exclusion Criteria: * Patients with severe cognitive impairment who could not understand simple verbal commands * Those who had severe dysarthria to prevent verbal communication * Those with unilateral neglect syndrome * Those with loss of sensation in the upper extremity of the hemiplegic side * Those with botulinum toxin-A injected to the hemiplegic upper extremity muscles * Those with previous shoulder-related trauma or pain history * Those with other accompanying neurological disease were excluded from the study.

Locations (1)

University of Health Sciences, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital

Istanbul, Bahçelievler, Turkey (Türkiye)

Outcomes

Primary Outcomes

Change from baseline Fugl-Meyer Assessment score at 30 sessions, 6 weeks

Upper extremity functionality, min-max: 0-66, "0" indicates no function of upper extremity, "66" indicates the highest functionality of upper extremity as possible.

Time frame: First evaluation: immediately before starting the treatment; the last evaluation: at the end of the treatment of 6 weeks

Secondary Outcomes

Change from baseline Visual Analog Scale (horizontal) value at 30 sessions, 6 weeks

Hemiplegic shoulder pain, 0-10 cm scale, "0" shows no pain at hemiplegic shoulder, "10" shows unbearable pain intensity at hemiplegic shoulder

Time frame: First evaluation: immediately before starting the treatment; the last evaluation: at the end of the treatment of 6 weeks

Change from baseline modified Ashworth scale value at 30 sessions, 6 weeks

Upper extremity spasticity, 0: No increase in tone, 1: slight increase in tone giving a catch when slight increase in muscle tone manifested by the limb was moved in flexion or extension. 1+: slight increase in muscle tone, manifested by a catch followed by minimal resistance throughout (ROM ) 2: more marked increase in tone but more marked increased in muscle tone through most limb easily flexed 3: considerable increase in tone, passive movement difficult 4: limb rigid in flexion or extension

Time frame: First evaluation: immediately before starting the treatment; the last evaluation: at the end of the treatment of 6 weeks

Data from ClinicalTrials.gov

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