Postural Decoding for Post-Stroke Shoulder Pain: A RCT.

Condition(s) studied

Investigational drug(s) / intervention(s)

Postural Decryption Technique: Assessment: PDT begins with visual inspection and palpation to check postural alignment and identify joint or muscle imbalances. Evaluations proceed distal to proximal, examining the spine and shoulder complex in coronal, sagittal, and transverse planes to assess symmetry and neutral positioning. Treatment Process: PDT applies the 4R Technique: 1. Reposition - Correct joint alignment. 2. Restore - Release muscle tension and adhesions. 3. Reinforce - Strengthen stabilizing muscles. 4. Retrain - Improve movement patterns and posture. Key Techniques: 1. Spinal and Shoulder Adjustments: Manual traction, mobilizations, and stretches. 2. Joint Mobilization: Multi-directional gliding within pain-free ranges. 3. Trigger Point Therapy: 5-10 seconds of pressure to relieve localized pain. 4. Proprioception Training: Balance challenges to improve stability and control.

Traditional Chinese Medicine (TCM) Massage Therapy: Definition: A manual therapy based on Traditional Chinese Medicine (TCM) principles, using techniques like kneading, pressing, rolling, and stretching to relieve pain, improve circulation, and enhance mobility. Key Features: 1. Techniques: Soft tissue manipulation, joint mobilization, and acupressure. 2. Focus: Pain relief, joint function recovery, and muscle relaxation. Treatment Plan: 4 weeks, 5 sessions per week, 40 minutes per session.

Study summary

Brief Summary

Purpose of the Study:

This clinical trial aims to determine whether Postural Decryption Technique can effectively treat hemiplegic shoulder pain (HSP) in patients recovering from stroke. It also seeks to assess the safety of this technique. The study will compare the effectiveness of the Postural Decryption Technique with traditional massage therapy to find out which method provides better pain relief and improves shoulder function.

Key Research Questions:

1. Can the Postural Decryption Technique reduce shoulder pain and improve range of motion in HSP patients?
2. Is the Postural Decryption Technique more effective than traditional massage therapy?
3. Is the Postural Decryption Technique safe, and are there any side effects or discomfort during treatment?

Study Design:
4. Researchers will recruit 48 participants with HSP and randomly divide them into two groups:

Treatment Group: Participants will receive therapy using the Postural Decryption Technique.

Control Group: Participants will undergo traditional massage therapy.

What Participants Will Do:

Receive treatment 5 times per week, 40 minutes per session, for 4 weeks. Undergo evaluations before treatment, 2 weeks after treatment begins, and at the end of 4 weeks to measure pain relief and shoulder function improvement.

Undergo musculoskeletal ultrasound to assess changes in soft tissue and joint structure.

Evaluation Methods:

1. Pain Assessment: Pain levels will be measured using the Visual Analog Scale (VAS).
2. Range of Motion (ROM): Tools will be used to measure the angles of shoulder movement.
3. Postural Assessment: The position of the scapula and spine will be measured to evaluate postural alignment improvements.
4. Daily Activity Ability: Progress in daily tasks will be recorded using the Barthel Index questionnaire.

Significance of the Study:

This study aims to validate whether the Postural Decryption Technique is a more effective and safer treatment for HSP compared to traditional massage therapy. If proven effective, it could offer a new rehabilitation approach to reduce pain, restore function, and improve the quality of life for stroke survivors.

Safety Monitoring:

Researchers will closely monitor participants for any signs of discomfort or adverse effects during the treatment process. Participants are free to withdraw from the study at any time if they experience any issues.

Conclusion:

The ultimate goal of this study is to identify a better treatment option for HSP in stroke patients. The results are expected to support the application of the Postural Decryption Technique as a safe and effective rehabilitation method for broader clinical use.

Eligibility

Primary outcome measure(s)

• VAS（Visual Analog Scale） — The assessment time points are before treatment, 2 weeks after treatment, and 4 weeks after treatment.
  In the Visual Analog Scale (VAS) scoring system, patients are presented with an unmarked line that is 10 centimeters long. Patients indicate their level of pain by marking a point along the line. The position of the mark is measured using a ruler, yielding a corresponding numerical value. The VAS score ranges from 0 to 10, where 0 represents no pain and 10 represents the most severe pain. Higher scores indicate greater pain intensity.
• Range of motion，ROM — The assessment time points are before treatment, 2 weeks after treatment, and 4 weeks after treatment.
  A goniometer is used to measure the flexion, abduction, and extension range of motion (ROM) of the shoulder joint in both groups of patients.
• The absolute value of the vertical distance difference between the medial superior angle of the scapula on the affected side and the spinous process of the second thoracic vertebra (T2). — The assessment time points are before treatment, 2 weeks after treatment, and 4 weeks after treatment.
  The patient sits comfortably with arms relaxed at their sides. The medial superior angle of the scapula is marked as Point 1, and the spinous process of the second thoracic vertebra (T2) is marked as Point 2. A ruler or measuring tape is used to measure the vertical distance between these two points. The absolute value of the distance difference before and after treatment is recorded to evaluate the effectiveness of the intervention, with a smaller difference indicating improved scapular alignment and postural symmetry.

Trial sites (1)