Bobath Approach On Hemiplegic Shoulder Pain

The Effect Of Bobath Approach On Hemiplegic Shoulder Pain, Spasticity And Upper Extremity Functionality In Stroke Patients: A Prospective, Randomized, Controlled And Single-Blind Trial

In this study, it is investigated that whether Bobath approach is superior to conventional physiotherapy in terms of improving hemiplegic shoulder pain, spasticity and upper extremity functionality in stroke patients.

Objective: This study aims to determine the effect of Bobath approach on hemiplegic shoulder pain, spasticity and upper extremity functionality in stroke patients.

Patients and Methods: For this prospective, randomized, controlled and single-blind trial, 30 stroke patients aged 40-65 years with hemiplegic shoulder pain were included. Patients were divided into two groups and randomized into these groups. Only conventional physiotherapy was applied to the control group, whereas both conventional physiotherapy and Bobath exercises were also applied to the experimental group. Visual analog scale (horizontal) for shoulder pain, modified Ashworth scale for spasticity and Fugl-Meyer assessment of the upper extremity for functionality were used for both pre-test and post-test.

Inclusion Criteria:

• Patients between the ages of 40 and 65
• Patients who had a stroke for the first time and had a disease duration of at least four weeks
• Patients who were diagnosed with ischemic or hemorrhagic stroke
• Patients who had Brunnstrom stage 3, 4 or 5 and had hemiplegic shoulder pain were included in the study.

Exclusion Criteria:

• Patients with severe cognitive impairment who could not understand simple verbal commands
• Those who had severe dysarthria to prevent verbal communication
• Those with unilateral neglect syndrome
• Those with loss of sensation in the upper extremity of the hemiplegic side
• Those with botulinum toxin-A injected to the hemiplegic upper extremity muscles
• Those with previous shoulder-related trauma or pain history
• Those with other accompanying neurological disease were excluded from the study.