"The Effect of Hemiplegic Shoulder Pain on Balance, Upper Extremity Function and Quality of Life"

Author(s):  
2021 ◽  
Vol 67 (2) ◽  
pp. 211-217
Author(s):  
Hilal Yeşil ◽  
Sibel Eyigör ◽  
Menekşe İnbat ◽  
Ferah Bulut

Objectives: This study aims to investigate the effect of complex decongestive therapy (CDT) on the kinesthetic sense of hands, upper extremity function, and the quality of life in patients with breast cancer-related lymphedema (BCRL). Patients and methods: Between August 2018 and August 2019, total of 50 women with BCRL (mean age: 56.5±9.6 years; range, 36 to 71 years) were included in the study. Kinesthetic sense of the hand, upper extremity function (Disabilities of the Arm, Shoulder and Hand [DASH]), quality of life (European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire [EORTC QLQ-C30]), and arm volume of all patients were evaluated before and after the treatment. All patients received CDT for 20 sessions for 1 h over a total of four weeks. Results: A statistically significant decrease in the volume of the involved extremity was observed after the treatment (p<0.001). There was a significant decrease in the symptom score (p<0.001) and a significant improvement in the general health status and functional scales of the EORTC QLQ-C30 (p<0.001 and p=0.012, respectively). The DASH scores and visual and kinesthetic sense scores of the patients significantly improved after the treatment (p=0.016, p=0.008, and p<0.001, respectively). Conclusion: Our study results show that BCRL is a serious complication which may lead to impairment in the kinesthetic sense of hand and upper extremity function with the increased arm volume. The CDT is an effective and safe method not only to achieve significant volume reduction in the extremities, but also to achieve favorable results in managing these problems.


2015 ◽  
Vol 25 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Müfit Akyüz ◽  
Halil Ünalan ◽  
Deniz Palamar ◽  
Alev Demirdali ◽  
Ayşe Kutlu ◽  
...  

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Aman Saini ◽  
Audrey Zucker-Levin ◽  
Benjamin McMillan ◽  
Pawan Kumar ◽  
Sarah Donkers ◽  
...  

Background. Activities of daily living and quality of life (QOL) are hindered by upper extremity (UE) impairments experienced by individuals with multiple sclerosis (iMS). The Nine-Hole Peg Test (9-HPT) is most frequently used to measure UE function. However, it does not measure peoples’ ability to perform routine tasks in daily life and may not be useful in iMS who cannot pick up the pegs utilized in the 9-HPT. Therefore, we evaluated three measures to explore a more comprehensive assessment of UE function: Upper Extremity Function Scale (UEFS), Action Research Arm Test (ARAT), and the 9-HPT. The objectives were to quantitatively assess the relationship between these measures of UE function, understand if the measures correlate with QOL as calculated by the MS Quality of Life-54 (MSQOL-54), and to determine differences in the measures based on employment status. Methods. 112 (79 female) iMS were prospectively recruited for this descriptive correlational study. Inclusion criteria were as follows: confirmed diagnosis of MS or clinically isolated syndrome, age ≥ 18 years, and ability to self-consent. All statistical analyses including Spearman’s correlation coefficient ( r s ) and Kruskal-Wallis tests were performed using SPSS. Results. A moderate correlation ( r s = − 0.51 ; p < 0.001 ) was found between the ARAT and 9-HPT scores for the more impaired hand. Likewise, a moderate correlation was found between UEFS and the physical health composite scores (PHCSs) of MSQOL-54 ( r s = − 0.59 ; p < 0.001 ). Finally, performances on ARAT, 9-HPT, and UEFS differed between the employed individuals and those on long-term disability ( p = 0.007 , p < 0.001 , and p = 0.001 ). Conclusion. The UEFS moderately correlated with the QOL measure, and considering the UESF is a patient-reported outcome, it could be used to complement routinely captured measures of assessing UE function. Further study is warranted to determine which measure, or combination of measures, is more sensitive to changes in UE function over time.


Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2939-2947 ◽  
Author(s):  
Alma R Hernández-Ortíz ◽  
Raquel Ponce-Luceño ◽  
Carlos Sáez-Sánchez ◽  
Olga García-Sánchez ◽  
César Fernández-de-las-Peñas ◽  
...  

Abstract Objectives To investigate the effects of applying dry needling into a trigger point (TrP) or non-TrP area in people who have suffered a stroke and to investigate if the effects of dry needling are maintained at six-week follow-up. Methods A controlled, repeated-measures, crossover, double-blinded randomized trial was conducted. Nineteen patients with hemiparetic shoulder pain after a stroke event were randomly assigned to receive a single multimodal treatment session combined with TrP dry needling or non-TrP dry needling. The neuro-rehabilitation session included modulatory interventions targeting the central nervous system. Spasticity (Modified Ashworth Scale), shoulder pain intensity (numerical pain rate scale, 0–10), and upper extremity function (Motor Evaluation Scale for Upper Extremity in Stroke [MESUPES], Reaching Performance Scale [RPS]) were assessed before (baseline) and one, two, three, four, five, and six weeks after the treatment session by a blinded assessor. All participants received both sessions in a randomized order where they were followed up for six weeks before receiving the opposite treatment and then followed up for another six weeks. Results Changes in muscle tone (all P &gt; 0.266) and upper extremity function (MESUPES: F = 0.544, P  = 0.465; RPS close task: F = 0.820, P = 0.371; RPS far task: 0.830, P  = 0.368) were similar after both interventions at all follow-up periods. The decrease in shoulder pain was higher within the TrP dry needling group as compared with the non-TrP dry needling group, particularly at two and four weeks (P  = 0.01). Conclusions The effect of dry needling on muscle tone (spasticity) and upper extremity function is not related to its application in or outside of a TrP area. The effect of dry needling on shoulder pain was slightly superior when applied over a TrP in poststroke people. These effects were maintained six weeks after treatment.


2019 ◽  
Vol 36 (03) ◽  
pp. 213-222 ◽  
Author(s):  
Sara van Bekkum ◽  
Tim de Jong ◽  
Michiel Zuidam ◽  
Marc A. M. Mureau

Abstract Background Microsurgical reconstruction of upper extremity injuries is often challenging, and the resulting impact on the quality of life (QoL) may be significant. However, there is a lack of knowledge on long-term patient-reported QoL. Methods In a retrospective long-term follow-up study, all consecutive patients with an upper extremity injury who had undergone a free flap reconstruction were identified and categorized into three groups based on the type of injury. Patient-reported upper extremity function and QoL were assessed using three validated questionnaires: the 36-item Short Form Health Survey (SF-36), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the Michigan Hand Outcomes Questionnaire (MHQ). Results A total of 61 patients were identified, of whom 10% had undergone a free flap reconstruction for soft tissue loss only, 62% for an injury accompanied by a fracture, and 28% for a (sub) total amputation. Twenty-one (44%) patients responded to the questionnaires, with a mean follow-up time of 9.7 ± 6.2 years. Patients, on average, reported poorer SF-36 “physical component score” and “role limitations due to physical health” scores compared with Dutch norms. Also, they reported poorer mean DASH scores compared with the general population, indicating worse upper extremity function. Mean MQH scores were lower for the injured side compared with the noninjured side. Pain correlated negatively with the total scores of DASH, MHQ, and SF-36. Conclusion Free flap upper extremity reconstruction is challenging. At 10 years of follow-up, the injury and its treatment continued to have a significant impact on the upper extremity function and daily QoL, with chronic pain being an important factor negatively affecting these outcomes.


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