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Protocol to prevent shoulder-hand syndrome after stroke.

I Kondo1, K Hosokawa, M Soma

  • 1Department of Rehabilitation Medicine, Institute of Brain Science, Hirosaki University, Japan. noukenrk@cc.hirosaki-u.ac.jp

Archives of Physical Medicine and Rehabilitation
|November 2, 2001
PubMed
Summary

A new protocol restricting passive arm movement significantly reduced shoulder-hand syndrome (SHS) incidence in stroke survivors. This intervention offers a promising approach for preventing SHS post-stroke.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Clinical Trials

Background:

  • Shoulder-hand syndrome (SHS) is a common complication after stroke, leading to significant upper extremity dysfunction.
  • Effective prevention strategies for SHS are crucial for improving patient outcomes and recovery.

Purpose of the Study:

  • To evaluate the effectiveness of a specific protocol aimed at restricting passive movement of the affected upper extremity in preventing SHS after stroke.
  • To assess the impact of controlled passive movement and patient-led restriction on SHS incidence.

Main Methods:

  • A before-and-after trial design was employed, comparing a group of 81 stroke patients treated with the protocol (1994-1996) to a historical control group of 71 patients treated without the protocol (1991-1994).
  • The intervention involved a 4-month protocol of controlled passive movement by therapists and restriction of passive movement by patients.

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  • Outcome measures included swelling index, SHS diagnostic criteria, Brunnstrom stage, and sensory disturbance evaluations.

    • Main Results:

    • The incidence of SHS in the group treated with the protocol was 18.5% (15 patients), compared to 32.4% (23 patients) in the control group.
    • This reduction in SHS incidence was statistically significant (chi(2) = 3.885, p < .05).

    Conclusions:

    • The implemented protocol for restricting passive upper extremity movement demonstrated effectiveness in preventing the development of shoulder-hand syndrome after stroke.
    • This finding suggests that proactive management of upper extremity movement can mitigate SHS risk in stroke rehabilitation.