Project Details
Abstract
Hemiplegic shoulder pain affects from 16%-84% of stroke patients and fatigue occurs among 39%-72%
of stroke victims, which can have an adverse impact on rehabilitation outcomes by interrupting
treatment process, daily functions, and quality of life (QOL) for stroke patients. Considering the
high prevalence and detrimental effects of poststroke shoulder pain and fatigue, it is vital for
monitoring these symptoms and therapeutic interventions to be developed for those suffering from
poststroke pain and fatigue. Therefore, to validate existing assessments of pain/fatigue, and to
evaluate the efficacy of potential pain/fatigue interventions are needed.
A vertical Numerical Rating Scale with Face Rating Scale (NRS-FRS) could be used by all stroke
patients as pain and fatigue measurement. The Brief Pain Inventory (BPI) and Brief Fatigue
Inventory (BFI) measure intensity and interference, which might provide more information. The first
aim of this research will be to examine the psychometric properties of the vertical NRS-FRS, BPI,
and BFI.
Functional electrical stimulation (FES) appears to offer benefits in relieving painful hemiplegic
shoulder. Electrical stimulation of the posterior deltoid and supraspinatus muscles has shown
beneficial effects on pain, subluxation, range of motion, and arm function. It is suggested that
graded treadmill training (GTT) could be useful in relieving fatigue by improving fitness reserve
and lowering of the energy cost of hemiparetic gait. For non-ambulatory stroke patients, body
weight supported treadmill training (BWSTT) is an encouraging intensive, task-specific practice.
Therefore, the second aim of this research will investigate whether the combined therapy of FES and
GTT (FES-GTT) or that of FES and BWSTT (FES-BWSTT) could reduce hemiplegic shoulder pain and
poststroke fatigue as compared with conventional rehabilitation (CR). Whether interventions could
lead to better functional performance and higher QOL would be of interest.
This 3-year project will be implemented in four stages and will recruit 160 patients with chronic
stroke. At the first stage, we will conduct a test-retest study to investigate the reliability and
validity of outcome measures on hemiplegic shoulder pain and poststroke fatigue in 80 patients. At
the second stage, we will conduct a randomized controlled trial (RCT) to investigate the relative
effects of the FES-GTT versus CR for 40 ambulatory stroke patients with hemiplegic shoulder pain,
poststroke fatigue, and moderate-to-mild motor impairment. At the third stage, we will conduct
another RCT to investigate the relative effects of the FES-BWSTT versus CR for 40 non-ambulatory
stroke patients with hemiplegic shoulder pain, poststroke fatigue, and moderate motor impairment.
Treatment regimens will be designed to ensure that patients in the 2 groups at stage 2 and 3
receive an equivalent intensity of treatment (1 hour/day, 3 days/week for 4 weeks). The fourth
stage determines clinimetric properties of the outcome measures.
We anticipate this research will shed light on metric properties of outcome measures of pain and
fatigue and the effects of the combined therapy for stroke patients. The overall findings will
contribute to guide the choice of proper assessment tool and the development of effective
rehabilitation programs.
Project IDs
Project ID:PC10205-0110
External Project ID:NSC102-2314-B182-003
External Project ID:NSC102-2314-B182-003
Status | Finished |
---|---|
Effective start/end date | 01/08/13 → 31/07/14 |
Keywords
- hemiplegic shoulder pain
- poststroke fatigue
- functional electrical stimulation
- graded treadmill training
- stroke rehabilitation
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