[Effect of slow stroke back massage [SSBM] on shoulder pain and hand function in patients with stroke]

Shoulder pain is a consequence of hemiplegia among patients with stroke. It makes patient to be dependent to others in their daily living activities. This study aimed to determine the effect of the slow stroke back massage [SSBM] on shoulder pain and hand function among patients with stroke. In this semi-experimental study, 34 patients were recruited among from 70 patients who reffered to rehabilitation center in 2010, according to the inclusion criteria. Participants were randomly allocated into two groups of control and experiment. In the intervention group, the SSBM was implemented for 10 minutes through seven consecutive sessions. Shoulder pain and hand function were measured using the visual pain scale [Visual Analog Scale], and the researcher-made "affected hand function in ADL" instrument, respectively. The measurement was done before and 24 hours after the last session of the intervention. Data were analyzed using descriptive and inferential statistical tests [independent t-test and paired t-test]. At baseline, the mean scores of shoulder pain were 8.4 in both experimental and control groups [P=0.999]. After the intervention, the mean scores of shoulder pain were 1.13 and 8.40 in experimental and control groups, respectively [P<0.001]. At baseline, the mean scores of hand function were 7.46 and 8.93 in the experimental and control groups, respectively [P=0.752]. After the intervention, the mean scores of hand function reached 9.13 and 8.6 in the experimental and control groups, respectively [P=0.918]. According to the results of the study, applying the SSBM as a treatment procedure and care plan by health care providers can be considered as an effective intervention to prevent or reduce shoulder pain and consequently to improve motor function of affected hand in patients with hemiplegia after stroke

Estratégias de fisioterapia com enfoque na prevenção da dor no ombro de pacientes hemiplégicos: revisão narrativa da literatura / Strategy of physiotherapy with emphasis in prevention hemiplegic shoulder pain: narrative review of literature

O Acidente Vascular Encefálico causa grandes complicações quanto às desabilidades físicas para os indivíduos acometidos, e a recuperação funcional constitui um grande desafio. A dor no ombro do paciente hemiplégico é uma complicação frequente que causa importante limitação para o programa de reabilitação. Estratégias de fisioterapia como posicionamento articular, uso de órtoses e posicionadores diversos, cinesioterapia e eletroterapia são sugeridas como prevenção para a dor no ombro desses indivíduos. O objetivo deste estudo foi apontar as estratégias de fisioterapia utilizadas na prevenção da dor no ombro hemiplégico. Foi realizada uma revisão de literatura em bases de dados eletrônicas e livros, no período de 1990 a 2006. Os descritores utilizados foram: Acidente Vascular Encefálico, stroke, fisioterapia, physiotherapy, hemiplegia, hemiplegic, dor de ombro, shoulder pain, prevenção&controle, e prevention & control. Os estudos foram agrupados e analisados de forma descritiva por tipo, número de participantes, estratégias de prevenção, desfecho e estratégias de avaliação, e conclusão. A fisioterapia é indicada para indivíduos com dor no ombro hemiplégico com objetivo de prevenção e tratamento. Os procedimentos encontrados enfocam o posicionamento do paciente, posicionadores, cinesioterapia e eletroestimulação. Porém, são necessários estudos que determinem a eficácia e a melhor estratégia de fisioterapia para prevenção da dor no ombro.

The preemptive analgesic effect of celecoxib for day-case diagnostic laparoscopy.

In a randomized trial, the preemptive analgesic effect of celecoxib in 110 infertile women undergoing day-case diagnostic laparoscopy was studied at King Chulalongkorn Memorial Hospital, Bangkok, Thailand. The patients randomly received either 200 mg celecoxib or placebo orally 2 hours before diagnostic laparoscopy. The post-operative shoulder pain and wound pain were self assessed and recorded, using Visual Analogue Scores (VAS) at 1, 2, 4, 12, and 24 hours. Total post-operative analgesic requirements were recorded at 24 hours. The mean Visual Analogue Scores (VAS) of shoulder pain in celecoxib group was statistically lower than those of the placebo group (p = 0.04). Nevertheless, the mean VAS of wound pain and the total post-operative analgesic requirements were not significantly different. It was concluded that the preemptive celecoxib in day-case diagnostic laparoscopy might have the advantage of decreasing post laparoscopic shoulder pain.

Hombro doloroso en el hemipléjico adulto / Painful shoulder in the adult hemiplegic

En esta revisión bibliográfica se reúnen antecedentes acerca del problema del hombro doloroso en el hemipléjico adulto, publicados preferentemente durante los últimos años. En un intento por aclarar la fisiopatología de este problema se presentan diversos factores predisponentes, que han sido estudiados con distintos énfasis, y se plantea la posible relación entre ellos, la que conduciría a la presentación del cuadro doloroso. Este cuadro parece ser altamente posible de prevenir, por lo que el terapista físico debería estar preparado para ello