Shoulder Pain after Recent Stroke (SPARS)

  • Research type

    Research Study

  • Full title

    Hemiplegic shoulder pain – A pilot study to investigate the incidence of early-onset shoulder pain in stroke patients and how this correlates with the development of shoulder pain at 8-10 weeks.

  • IRAS ID

    164294

  • Contact name

    Martine Nadler

  • Contact email

    martine.nadler@stgeorges.nhs.uk

  • Sponsor organisation

    St George's University Hospitals NHS Foundation Trust

  • ISRCTN Number

    ISRCTN00000000

  • Clinicaltrials.gov Identifier

    NCT02574000

  • Duration of Study in the UK

    0 years, 6 months, 0 days

  • Research summary

    How many patients develop hemiplegic shoulder pain (HSP) very early after stroke? Which patients are most at risk of HSP 8-10 weeks later?

    Stroke is the leading cause of adult disability in the United Kingdom. Up to two thirds of stroke patients experience hemiplegic shoulder pain (HSP) in the stroke shoulder weeks or months after their stroke. HSP significantly reduces patients’ quality of life which is often already impacted by having had a stroke. HSP further reduces patients’ ability to use their hand.

    HSP has many causes which makes it very difficult to treat. The longer a patient has HSP the worse the outcome of treatment. Patients with HSP at 4 months are extremely likely to have continuing pain at one year. Data from a St. George’s audit showed that half of patients developed pain in the affected shoulder within three days of admission, despite current preventive strategies from stroke specialist nurses and therapists. This suggests we need to intervene at the point of admission to prevent HSP from developing.

    • We will use the validated ShoulderQ questionnaire and clinical examination in 163 stroke patients admitted to St George’s hyper-acute stroke unit to identify the proportion who develop HSP within 72 hours.

    • We will repeat the ShoulderQ and clinical examination in these patients attending the St George’s stroke follow-up clinic at 8-10weeks. Patients not attending will be followed up by telephone using the ShoulderQ only.

    • We will identify the assessment methods (ShoulderQ or clinical examination) which best correlate with predicting HSP at 8-10 weeks.

    • This will enable us to stratify patients into groups and calculate recruitment rates, follow-up feasibility and power calculations to plan for future clinical trials to a) prevent development of HSP and b) treat HSP.

  • REC name

    Yorkshire & The Humber - Leeds West Research Ethics Committee

  • REC reference

    15/YH/0480

  • Date of REC Opinion

    22 Oct 2015

  • REC opinion

    Favourable Opinion