Objective: The purpose of this study was to investigate the effect of comprehensive postural instructions and range of motion (ROM) exercises via educational videos for shoulder injury prevention and functional improvement of the hemiplegic shoulder after acute stroke.

Methods: In this prospective cohort study, 48 subacute stroke patients with hemiplegia were enrolled and divided into 2 groups (23 in experimental group and 25 in control group). In the control group (n = 25), the patients performed conventional rehabilitation for 5 days per week. In the experimental group (n = 23), the patients received not only conventional rehabilitation but also additional postural instructions and regular ROM exercises via educational videos for hemiplegic shoulders for 15 minutes twice per day for 5 days per week during their hospital stay. Main outcome measures, including the presence and severity of pain, motor function, and sonography on hemiplegic shoulder, were assessed.

Results: More motor recovery improvement was found in the experimental group (P < .05). In the supraspinatus tendon, a significantly increased frequency in tendinopathy or tear was observed between admission (12%) and before discharge (40%) in the control group (P < .05), but no difference was observed in the experimental group. In the subdeltoid bursa, effusion or bursitis was significantly reduced between admission (30.4%) and before discharge (8.7%) in the experimental group (P < .05).

Conclusion: These findings suggest that comprehensive postural instructions and ROM exercises via educational videos during inpatient rehabilitation for subacute stroke patients could improve motor recovery and limit shoulder injury in stroke patients with hemiplegia.

Author keywords: Stroke, Hemiplegia, Rehabilitation, Shoulder Injuries

Author affiliations:  YCH, CYC, CPL, HLC: Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan;  YCH: Chang Gung University College of Medicine, Kaohsiung City, Taiwan;  CPL: Gung University College of Medicine, Kaohsiung City, Taiwan; LW: Pediatric Department, Pojen Hospital, Kaohsiung City, Taiwan; HLC: E-Da Hospital, Kaohsiung City, Taiwan.

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