Effectiveness of caregiver education for prevention of shoulder pain in acute stroke survivors: A randomised controlled trial

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 Chisquare 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.