Stroke Hemiplegic Shoulder Pain: Ultrasound Findings and VAS (Cross-Sectional)

The Relationship Between Shoulder Ultrasound Findings and Pain Levels in Acute/Subacute Stroke Patients: A Cross-Sectional Study

Hemiplegic shoulder pain is a frequent complication after stroke and may be associated with structural abnormalities detectable by musculoskeletal ultrasound. This prospective cross-sectional observational study aims to evaluate the relationship between shoulder ultrasound abnormality score and pain severity in patients with post-stroke hemiplegic shoulder pain. Pain severity will be assessed using the Visual Analog Scale (VAS) for rest, movement, and night pain. Shoulder ultrasound will be performed using a standardized scoring system to quantify structural abnormalities. The primary objective is to investigate whether ultrasound abnormality burden is associated with pain severity in different clinical conditions (rest, exercise, and night).

Study Overview

• Status: Recruiting
• Conditions: Hemiplegic Shoulder Pain

Detailed Description

Hemiplegic shoulder pain is a common complication after stroke and may negatively affect rehabilitation outcomes. Structural abnormalities such as rotator cuff pathology, biceps tendon disorders, bursitis, adhesive capsulitis, and glenohumeral subluxation can be evaluated using musculoskeletal ultrasound.

This prospective cross-sectional observational study aims to investigate the relationship between shoulder ultrasound abnormality score and pain severity in patients with post-stroke hemiplegic shoulder pain. Adult stroke patients with hemiplegic shoulder pain will be evaluated at admission.

Pain severity will be assessed using the Visual Analog Scale (VAS) separately for rest, movement, and night pain. Shoulder ultrasound will be performed using a standardized protocol, and a total ultrasound abnormality score will be calculated.

The primary objective is to evaluate the association between ultrasound abnormality score and pain severity. Secondary analyses will assess the relationship between specific ultrasound findings and pain severity.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara, Turkey (Türkiye)
    • Recruiting
    • Ankara Etlik Şehir Hastanesi
    • Contact: ayşe naz kalem, md; Phone Number: +905333626947; Email: kalemnaz@gmail.com
    • Contact: aliye aygün, md; Phone Number: +905454764771; Email: aliyeaygunn@hotmail.com
    • Principal Investigator: nihal tezel, Associate Professor
    • Sub-Investigator: aliye aygün, MD,Resident Physician
    • Sub-Investigator: ayşe naz kalem, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adult patients with stroke and hemiplegic shoulder pain who are admitted to the physical medicine and rehabilitation clinic of Ankara Etlik City Hospital will be included. Eligible patients are between 18 and 75 years of age and within 2 weeks to 6 months after stroke. All participants will undergo clinical assessment and shoulder ultrasound examination at admission.

Description

Inclusion Criteria:

1. Being between 18-75 years of age
2. Patients with a history of stroke within the last 2 weeks to 6 months
3. Patients with shoulder pain on the hemiplegic side
4. Mini-mental status test score >25

Exclusion Criteria:

1. Motor aphasic patient group
2. Patients with a history of previous surgery on the hemiplegic shoulder for any reason
3. Those with other diseases that can explain the shoulder pain
4. Those with neurodegenerative diseases that cause impairment in cognitive functions, such as dementia

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Post-stroke Hemiplegic Shoulder Pain Patients; Adult stroke patients with hemiplegic shoulder pain who are evaluated at admission. Pain severity is assessed using the Visual Analog Scale (VAS) for rest, movement, and night pain. Shoulder ultrasound is performed using a standardized protocol, and an ultrasound abnormality score is calculated to evaluate the relationship between structural abnormalities and pain severity.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Association between shoulder ultrasound abnormality score and pain severity	Relationship between total shoulder ultrasound abnormality score and Visual Analog Scale (VAS) pain scores (rest, movement, and night pain) assessed at admission.	At admission (single assessment on the same day as ultrasound)

Collaborators and Investigators

• Sponsor: Ankara Etlik City Hospital

Publications and helpful links

General Publications

• Pong YP, Wang LY, Huang YC, Leong CP, Liaw MY, Chen HY. Sonography and physical findings in stroke patients with hemiplegic shoulders: a longitudinal study. J Rehabil Med. 2012 Jun;44(7):553-7. doi: 10.2340/16501977-0987.
• Huang SW, Liu SY, Tang HW, Wei TS, Wang WT, Yang CP. Relationship between severity of shoulder subluxation and soft-tissue injury in hemiplegic stroke patients. J Rehabil Med. 2012 Sep;44(9):733-9. doi: 10.2340/16501977-1026.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2026
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): September 1, 2026

Study Registration Dates

• First Submitted: February 17, 2026
• First Submitted That Met QC Criteria: February 17, 2026
• First Posted (Actual): February 23, 2026

Study Record Updates

• Last Update Posted (Actual): February 23, 2026
• Last Update Submitted That Met QC Criteria: February 17, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Ultrasound; Visual Analog Scale; Hemiplegic Shoulder Pain
• Other Study ID Numbers: AEŞH-BADEK1-2025-682

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No