Effects of Hemiplegic Shoulder Pain

Study Overview
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Brief Summary
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The purposes of this study is to investigate the differences in upper extremity function, sleep quality, and functional independence between patients with and without hemiplegic shoulder pain (HSP). HSP is defined as musculoskeletal pain in the affected shoulders of individuals after stroke.Numerous studies have found an association between post-stroke shoulder pain and range of motion, sensory impairment, subluxation, spasticity, and complex regional pain syndrome. HSP is a problem that, starting from mild discomfort, leads to gradual functional impairment, ultimately resulting in increasing disability and decreased independence.In the literature, the relationship between HSP and upper extremity function, functional independence, and sleep quality has not been clarified.

Official Title
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Investigation of Upper Extremity Function, Sleep Quality, and Functional Independence in Patients With Hemiplegic Shoulder Pain

Conditions
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Stroke, Shoulder Pain

Intervention / Treatment
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* Other: Disabilities of the Arm, Shoulder, and Hand Questionnaire
* Other: Arm Motor Ability Test
* Other: Nine Hole Peg Test
* Other: Pittsburg Sleep Quality Index
* Other: Functional Independence Measure


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Over 18 years old Have had a stroke at least three months ago Volunteers who can understand or communicate test instructions Exclusion Criteria: Having a history of shoulder surgery Having serious shoulder problems before stroke Having other neurological conditions

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 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 |
| --- | --- |
| Patients with shoulder pain<br>Those who scored above 0 for shoulder pain on the Visual Analog Scale (VAS) were assigned to the group with shoulder pain | Other: Disabilities of the Arm, Shoulder, and Hand Questionnaire<br>* Upper limb function was assessed with the Turkish version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). The questionnaire DASH is a self-report instrument with 30 items. The total score ranges from 0 to 100, with higher scores indicating a worse upper limb function.<br>Other: Arm Motor Ability Test<br>* The test assesses hemiparetic upper extremity functional tasks.The increase in the scores of both subparameters of the scale, which is composed of the parameters of functional ability and quality of movement, indicates an improvement in the motor functions of the upper limbs.<br>Other: Nine Hole Peg Test<br>* Fine motor skills of the upper extremities were assessed.The patient was asked to insert the nine sticks in the box on the table into the holes in the other box as quickly as possible and then remove them immediately. As time increases, fine motor skills of the upper extremities decrease<br>Other: Pittsburg Sleep Quality Index<br>* Sleep quality was assessed using the this test.This scale, which provides a quantitative measure of sleep quality, is a 19-item self-report scale. The total score greater than 5 indicates poor sleep quality.<br>Other: Functional Independence Measure<br>* This test assessed functional capacity in activities of daily living.The higher a person's score, the higher the level of independence.<br>|
| Patients without shoulder pain<br>Those who scored 0 for shoulder pain on the Visual Analog Scale (VAS) were assigned to the group without shoulder pain | Other: Disabilities of the Arm, Shoulder, and Hand Questionnaire<br>* Upper limb function was assessed with the Turkish version of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH). The questionnaire DASH is a self-report instrument with 30 items. The total score ranges from 0 to 100, with higher scores indicating a worse upper limb function.<br>Other: Arm Motor Ability Test<br>* The test assesses hemiparetic upper extremity functional tasks.The increase in the scores of both subparameters of the scale, which is composed of the parameters of functional ability and quality of movement, indicates an improvement in the motor functions of the upper limbs.<br>Other: Nine Hole Peg Test<br>* Fine motor skills of the upper extremities were assessed.The patient was asked to insert the nine sticks in the box on the table into the holes in the other box as quickly as possible and then remove them immediately. As time increases, fine motor skills of the upper extremities decrease<br>Other: Pittsburg Sleep Quality Index<br>* Sleep quality was assessed using the this test.This scale, which provides a quantitative measure of sleep quality, is a 19-item self-report scale. The total score greater than 5 indicates poor sleep quality.<br>Other: Functional Independence Measure<br>* This test assessed functional capacity in activities of daily living.The higher a person's score, the higher the level of independence.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| DASH | Upper limb functions was assessed with DASH, AMAT, and Nine Hole Peg Test.The DASH total score ranges from 0 to 100, with higher scores indicating a worse upper limb function. | one hour | 
| AMAT | The increase in the scores of both subparameters of the AMAT scale, which is composed of the parameters of functional ability and quality of movement, indicates an improvement in the motor functions of the upper limbs. | one hour | 
| Nine Hole Peg Test | In the Nine hole peg test, fine motor skills of the upper extremities decrease as time goes on. | one hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sleep Qaulity | Sleep quality was assessed using the Pittsburg Sleep Quality Index (PSQI). The total score ranges from 0 to 21, and a total score greater than 5 indicates poor sleep quality | one hour | 
| Functional Independence | The Functional Independence Measure (FIM) assessed functional capacity in activities of daily living. The FIM Consists of 6 parts and analyzes motor and cognitive functions. The higher a person's score, the higher the level of independence. | one hour |