Observational Study of Hemiplegic Shoulder Pain After Recent Stroke

Study Overview
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Brief Summary
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This is an observational study to address the following questions. How many people develop stroke-shoulder pain within 3 days of stroke? How many people have stroke shoulder pain at 8-10 weeks after stroke? Does having stroke-shoulder pain within 3 days of stroke predict the likelihood of having stroke-shoulder pain at 8-10 weeks? What are the best bedside examination tests to identify stroke-shoulder pain?

Detailed Description
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Patients will be assessed very early after stroke (within 72 hours) and followed up 8-10 weeks later. Findings will enable planning of fully-powered randomised controlled trials of both, pain-prevention strategies and treatment.

Official Title
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Observational Study to Investigate Proportion of Patients With Hemiplegic Shoulder Pain Within 72 Hours Post-stroke and at Follow-up 8-10 Weeks Later.

Conditions
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Shoulder Pain, Hemiplegia, Stroke

Intervention / Treatment
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* Other: ShoulderQ which is a shoulder pain questionnaire
* Other: Clinical shoulder examination


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - Clinical diagnosis of haemorrhagic or ischaemic stroke Exclusion Criteria: Transient Ischaemic attack, Neurological symptoms due to causes other than acute stroke, Unconscious, Severe behavioural disturbance, Severe agitation, Severe dementia, For palliation, Totally unable to communicate using any method - written, verbal, pictures, gesture

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Single group baseline and follow-up<br>Single group of adult stroke patients assessed using ShoulderQ shoulder pain questionnaire and Clinical shoulder examination at two time-points: Baseline: within 72 hours post-stroke Follow-up: at 8-10 weeks post-stroke | Other: ShoulderQ which is a shoulder pain questionnaire<br>* Questions regarding shoulder pain at rest, during movement and at night with visual analogue scales. Factors affecting shoulder pain.<br>Other: Clinical shoulder examination<br>* Shoulder-Hand-Score (measuring pain, oedema, passive range of movement), muscle strength (using Oxford scale and National Institute of Health Stroke Scale (NIHSS) upper limbe motor and shoulder joint palpation (recording subluxation and soft-tissue pain).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline severity of hemiplegic shoulder pain at 8-10 weeks | Questionnaire including visual analogue scales | within 72 hours and 8-10 weeks | 
| Change from baseline Shoulder-Hand-Score at 8-10 weeks | Measurement of pain, oedema, passive range of shoulder abduction and passive range of shoulder external rotation | within 72 hours and 8-10 weeks | 
| Change from baseline NIH Stroke Score Upper limb (Motor Arm) at 8-10 weeks | Muscle Strength | within 72 hours and 8-10 weeks | 
| Change from baseline presence/absence of pain on palpation at 8-10 weeks | Palpation of shoulder joint line and surrounding soft tissues | within 72 hours and 8-10 weeks | 
| Change from baseline presence/absence of inferior glenohumeral subluxation at 8-10 weeks | Palpable gap in sub-acromial region with arm dependent | within 72 hours and 8-10 weeks |