Effectiveness of Caregiver Education for Prevention of Shoulder Pain in Acute Stroke Survivors: A Randomised Controlled Trial

Jerome Dany Praveen Raj; Sebestina Anita Dsouza; Amith Sitaram; Shashikiran Umakanth

doi:10.47985/dcidj.378

Jerome Dany Praveen Raj ⁽¹⁾, Sebestina Anita Dsouza ⁽²⁾, Amith Sitaram ⁽³⁾, Shashikiran Umakanth ⁽⁴⁾

(1) Lecturer, Department of Occupational Therapy, Christian Medical College, Vellore, Tamilnadu, India., India,

(2) Manipal Academy of Higher Education, India,

(3) Consultant in Stroke, Queen Elizabeth University Hospital, Glasgow, United Kingdom., United Kingdom,

(4) Manipal Academy of Higher Education, India

https://doi.org/10.47985/dcidj.378

Issue
Vol. 32 No. 1 (2021): Spring

Submitted
October 31, 2020

Published
May 6, 2021

Keywords:

Stroke, hemiplegic shoulder pain, caregiver education, acute care, discharge transition

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Abstract

Purpose: This study aimed to determine the effectiveness of caregiver education to prevent or reduce hemiplegic shoulder pain, a complication following stroke that adversely affects functional outcomes and prolongs rehabilitation.

Method: The study was a randomised controlled trial involving acute stroke survivors in the hospital and their primary caregivers. The participants were conveniently selected and randomly allocated to the experimental (n = 20) and control groups (n = 20) using block randomisation. The stroke survivors of both the study groups received conventional therapy. In the experimental group, caregivers participated in three individual sessions of the education programme for shoulder care, which comprised provision of information, demonstration and training. The outcome measures at pre-assessment were the Visual Analogue Scale (VAS) for shoulder pain and the Fugyl-Meyer Assessment for Upper Extremity for Motor Recovery. Caregiver feedback scores were obtained following the intervention. The VAS scores were obtained at 30 days following intervention and 30 days following post-assessment (follow-up assessment) through the posted envelopes. Mann-Whitney U test and Chi- square test were used for statistical analysis.

Results: There was no significant difference between the groups on VAS at follow-up assessment. The number of stroke survivors reporting “no pain” increased by 29% in the experimental group and decreased by 6% in the control group. Caregiver feedback scores were higher in the experimental group than in the control group (P < 0.001).

Conclusion: This study indicates that educating caregivers on shoulder care during acute management at the hospital, improves their confidence in handling and positioning the stroke survivor after discharge and could reduce hemiplegic shoulder pain.

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Authors

Jerome Dany Praveen Raj

Lecturer, Department of Occupational Therapy, Christian Medical College, Vellore, Tamilnadu, India.

https://orcid.org/0000-0002-6748-7664

Sebestina Anita Dsouza

Manipal Academy of Higher Education

sebestina.dsouza@manipal.edu (Primary Contact)

Amith Sitaram

Consultant in Stroke, Queen Elizabeth University Hospital, Glasgow, United Kingdom.

Shashikiran Umakanth

Manipal Academy of Higher Education

Author Biographies

Jerome Dany Praveen Raj, Lecturer, Department of Occupational Therapy, Christian Medical College, Vellore, Tamilnadu, India.

Jerome is a Lecturer at the Department of Occupational Therapy in Christian Medical College, Vellore, Tamilnadu, India. He has a Master's degree in Occupational Therapy and Neuro-Rehabilitation from Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka. He is interested in acute care, long-term care and community based rehabilitation.

Sebestina Anita Dsouza, Manipal Academy of Higher Education

Dr. Sebestina Anita Dsouza is a Professor at the Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education (MAHE). She has over 20 years of experience in clinical practice, teaching, administration and research. She is particularly interested in developing contextually relevant assessments and interventions in aging (fall prevention, dementia, caregiver support, healthy aging) and neurorehabilitation. She is the lead editor of the book “Concepts in Occupational Therapy: understanding Southern perspectives”. She is also the coordinator for the Center for Studies on Healthy Aging at MAHE.

Amith Sitaram, Consultant in Stroke, Queen Elizabeth University Hospital, Glasgow, United Kingdom.

Amith is a Consultant in Stroke at Queen Elizabeth University Hospital in Glasgow, United Kingdom. He also holds the post of Honorary Clinical Researcher at Institute of Neuroscience and Psychology, University of Glasgow. He completed a Fellowship in Stroke from University of Calgary, Canada.

Shashikiran Umakanth, Manipal Academy of Higher Education

Shashikiran is a Professor and Head of General Medicine at Dr. TMA Pai Hospital in Udupi, which is affliated to Manipal Academy of Higher Education, Manipal, Karnataka, India.

1.

Praveen Raj JD, Dsouza SA, Sitaram A, Umakanth S. Effectiveness of Caregiver Education for Prevention of Shoulder Pain in Acute Stroke Survivors: A Randomised Controlled Trial. DCIDJ [Internet]. 2021 May 6 [cited 2025 Feb. 5];32(1):66-80. Available from: https://dcidj.uog.edu.et/index.php/up-j-dcbrid/article/view/378

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