Effect of Allium Cepa in the Management of Shoulder Pain Post Stroke
Condition: Stroke
MeSH terms: Shoulder Pain; Stroke
Study type: Interventional
Phase: Early Phase 1

Summary: 
      One of the disabling consequences of stroke is hemipleic shoulder pain. Hemiplegic shoulder
      pain could be most important hinderance to upper extremity function after stroke . Evidence
      for rehabilitation approaches for shuolder pain suggested diverse approaches with strong need
      for further studies. This study planned to investigate the effect of Allium Cepa in the
      management of shoulder pain post stroke using four arms of the studying with three
      intervention groups and control group All participants who met study inclusion criteria and
      gave their consent shall be assessed at baseline for impairment (Fugl Meyer Assessment),
      activity limitation (Brief Pain Inventory) and participation restrictions (Stroke Impact
      Scale)
    

Detailed description: 
      Globally, stroke is the second most common cause of death and a major cause of disability.
      One of the disabling consequences of stroke is hemipleic shoulder pain which on its own could
      result in disability. Physical therapy is an integral part of post stroke rehabilitation, and
      plays an important role in the prevention and treatment of hemiplegic shoulder pain.
      Generally, patients with pain will most likely experience greater cognitive impairment and
      functional decline, lower quality of life, fatigue, depression and often poorly cooperate in
      rehabilitation. It was reported from a study that the ideal management of hemiplegic shoulder
      pain is to prevent it from happening in the first place, once the patient developed pain,
      resultant anxiety and over protection will follow. Hemiplegic shoulder pain can also
      interfere with arm recovery, reduce activity of daily living and markedly hinder
      rehabilitation.Similarly, a study have reported shoulder pain to cause considerable distress,
      discomfort, interference with rehabilitation, delay in discharge and that it is generally
      poorly managed. A recently updated Evidence-Based Review of Stroke Rehabilitation (EBRSR) on
      painful hemiplegic shoulder summarised 19 key points about painful hemiplegic shoulder; while
      all the 19 points are essential, the need for these study is closely related by some of these
      points these include Aggressive range of motion exercises (i.e. pullies) results in a
      markedly increased incidence of painful shoulder; a gentler range of motion program is
      preferred. Adding ultrasound treatments does not appear to improve shoulder range of motion,
      Treatment with surface neuromuscular electrical stimulation (NMES) early (< 6 months)
      post-stroke may reduce shoulder subluxation but not pain associated with shoulder hemiplegia.
      Surface NMES delivered after 6 months provides no additional benefits over conventional
      therapy on shoulder subluxation. Intramuscular NMES however, has been found to reduce
      shoulder pain up to 12 months post-therapy, Strapping/taping the hemiplegic shoulder does not
      appear to improve upper limb function, but may reduce pain, Further research is needed to
      determine the benefits of aromatherapy in combination with acupressure regarding its effects
      on reducing pain caused by shoulder hemiplegia and Massage therapy may reduce hemiplegic
      shoulder pain, anxiety, and other physiological functions (i.e. blood pressure, and heart
      rate) however, more research is still warranted. This study will therefore investigat the
      effect of Allium cepa(onion) in the management of shoulder pain post stoke.
    

Intervention name(s): Topical App. of Allium Cepa Extract; Phonophoresis of Allium Cepa Extract; Raw Mashed Allium Cepa Application; Standard Physiotherapy Group (SPG)
Intervention type(s): Biological; Biological; Biological; Other
Intervention description(s): Topical Application of Allium Cepa Extract (oil); Phonophoresis of Allium Cepa Extract (oil); Raw Allium Cepa (onion bulb) Mashed; This will consist of Massage and therapeutic exercise for the management of shoulder pain post stroke
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: participant will be randomly allocated into 4 groups Topical Application of Allum Cepa Extract, Phonophoresis of Allium Cepa Etract, Raw Mashed Allium Cepa Application and Standard Physiotherapy group ) the first 3 groups will be recieving standard physiotherapy management of shoulder pain post stroke just like those in the standard physiotherapy group in addition to specific treatment assigned to each of the groups
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment