Assessment and Management Practices for Post-Stroke Shoulder Pain Among Rehabilitation Professionals in Vietnam: A Cross-Sectional Survey.

چکیده اصلی

BACKGROUND: Post-stroke shoulder pain (PSSP) is a common complication that negatively affects functional recovery and rehabilitation outcomes. Despite the availability of evidence-informed management strategies, clinical practice may vary across settings, particularly in lower-and middle-income countries. PURPOSE: To investigate current assessment and management practices for PSSP among physical and occupational therapists in Vietnam and to identify potential evidence and practice gaps as well as the barriers to effective care. METHODS: A cross-sectional survey was conducted online among rehabilitation professionals working in stroke care in 14 hospitals across all regions of Vietnam. A structured questionnaire was designed to capture the actual practice information on assessment approaches, treatment strategies, preventive measures, and perceived barriers to PSSP management. Descriptive statistics were used to summarize responses, and comparisons between levels of clinical experience were performed. The results were also analyzed for their alignment with the evidence-informed rehabilitation principles. RESULTS: A total of 214 therapists (191 physical therapists and 23 occupational therapists) participated in the online survey. Most respondents reported that 25%-75% of their stroke patients experienced shoulder pain. Common assessment methods included shoulder subluxation, patient-reported pain, and range-of-motion evaluation. Only 53.74% of respondents reported using standardized outcome measures. Preventive strategies such as positioning and sling usage were widely implemented (70.64%). In treatment, 37.38% of therapists emphasized modalities, while 35.98% used combined approaches and 26.64% focused on mobility-based exercise. Key barriers included lack of long-term follow-up (65.42%), time constraints (45.79%), and inconsistent treatment approaches (45.79%). DISCUSSION: The findings revealed considerable variation in PSSP assessment and management practices among rehabilitation professionals in Vietnam, with a substantial proportion of respondents reporting treatment approaches centered on passive modalities. System-level barriers, including limited follow-up and time constraints, were frequently perceived by respondents as influencing their clinical practice. These findings may help inform future initiatives related to professional training, practice standardization, and development of context-specific guidelines for post-stroke shoulder pain management.

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