A Systematic Review of Clinical Practice Guidelines for the Management of Shoulder Pain in Patients with Stroke

Objectives: To assess the quality, scope, and consistency of relevant clinical practice guidelines (CPGs) recommendations for hemiplegic shoulder pain (HSP) management among stroke patients. Study design: A systematic review of CPGs. Setting: Publishing regions were North America, Europe, Asia, and Oceania. Subjects: Adult (> 18 years) stroke patients who had HSP. Methods: Seven databases were used to search for CPGs. A total of 267 articles were screened; 8 guidelines met the inclusion criteria. The Appraisal of Guideline for Research and Evaluation (AGREE-II) was used for evaluating the quality of the selected CPGs. Results: The recommendations of 5 high-quality guidelines for post-stroke HSP management were synthesized and 5 scopes of consistent recommendations were found comprising assessment, prevention, medical treatment, physical therapy treatment, and management of shoulder subluxation. Conclusion: The key recommendations proposed that the assessment should evaluate muscle tone and pain level; advice and education be provided to family members and caregivers on how to handle and position the shoulder correctly, and avoid exercises involving overhead pulleys to prevent HSP; medical treatment should consider the administration of analgesics, high doses of botulinum toxin injections, subacromial corticosteroid injections, and suprascapular nerve blocks; and that physical therapy approaches should employ active exercises, taping or strapping, and the management of shoulder subluxation via slings and electrical stimulation. Future up-to-date guidelines should consider all domains of AGREE-II in order to improve their quality

The effect of mindfulness movement therapy on arm and hand function in people with and without stroke

Upper extremity motor deficit is a big issue in patients with stroke. Mindfulness meditation may have potential to improve arm and hand function in stroke patients. However, there is no mindfulness programme specifically concerned with motor performance. Therefore, this thesis proposed a new protocol of a mindfulness movement therapy programme (MMTP) for improving arm and hand function in patients with stroke. There were 4 phases to this thesis, phase I; a systematic review of meditation for motor function in patients with stroke, phase II; a preliminary study in older adults, phase III; a randomised single-blind controlled trial in healthy older adults, and phase IV; a preliminary study in patients with stroke. In phase I, 13 studies were included for qualitative synthesis but no studies focused on the primary outcome of motor function. In phase II, MMTP improved motor performance speed of the upper limbs for both hands, especially in the trained upper limb (p=0.008) and affected mood (p=0.033) accompanied by improved sensorimotor and attentional functioning in the brain. In phase III, MMTP increased nerve conduction velocity (p=0.018) with no changes in the active control group. Moreover, motor performance speed improved in the trained upper limb (p<0.0001). In the last phase, MMTP improved spasticity of the elbow flexor (p=0.025) and finger flexors (p=0.034), mindfulness (p=0.027), and quality of life (p=0.043). It was concluded that MMTP might have the potential to add to the standard rehabilitation programme for improving motor performance of the upper limb in people with and without stroke. While this thesis provides promising evidence, larger clinical trials are needed to confirm the effects of MMTP as a new intervention for improving arm and hand function in patients with stroke

Abstracts of the 9th International Organisation of Physical Therapy in Mental Health Conference

This book contains the abstracts of the papers presented at the 9th International Organisation of Physical Therapy in Mental Health Conference, Organized by the International Organisation of Physical Therapy in Mental Health and Greek Scientific Section “Physiotherapy in Mental Health” of PanHellenic Physiotherapists’ Association, held on 4–6 May 2022. It is the biannual conference of the International Organization of Physical Therapy in Mental Health (IOPTMH), and we answered with success the question: Physiotherapy in mental health; what’s next? The highly qualified scientific program, the reputable presenters, and the venue altogether form a powerful motivation for both physiotherapists and other mental health professionals to attend this conference. Conference Title: 9th International Organisation of Physical Therapy in Mental Health ConferenceConference Theme: Physiotherapy in mental health; what’s next?Conference Date: 4–6 May 2022Conference Location: Crowne Plaza Athens - City Centre Hotel, 50, Michalakopoulou Str. GR 11528 AthensConference Organizer: International Organisation of Physical Therapy in Mental Health and Greek Scientific Section “Physiotherapy in Mental Health” of PanHellenic Physiotherapists’ AssociationConference Secretariat - Public Relations: Alpha Public Relations and Integrated Marketing S.A., 55, Pytheou Str. GR 11743 Athen