Multi-disciplinary Prevention Program

Brief Summary

About 70% of hemiplegic patients suffer from hemiplegic shoulder pain after stroke. This common occurrence is a cause for concern in the rehabilitation setting as it leads to impairment of functional outcomes induced by discomfort and delays in rehabilitation, important psycho-emotional repercussions as there is a correlation between upper arm pain and depression, a longer hospital stay. Poor management of hemiplegic shoulder pain can ultimately give rise to type 1 "complex regional pain syndrome" (CRPS I). There is no consensus on treatment, care pathways or useful devices for positioning acute stroke patients in the literature. Our objective is to compare the effectiveness of a new positioning procedure of the hemiplegic arm with conventional positioning (pillow and "shoulder-immobilisation" sling) in acute stroke patients. Patient's actions are focus in 4 points: * Positioning in bed, wheelchair and standing with specific materials (holds, sling in external rotation and abduction) * Be careful of shoulder's coaptation in care and functional activities (toilet, dressing, transfers) * A training of the patient and members of family on pathology, risk, use of material * Daily passive mobilisation of the upper member by a therapist.