Painful shoulder in hemiplegia

Area of Science:

• Neurology
• Rehabilitation Medicine
• Orthopedics

Background:

• Shoulder pain is a frequent complication after a cerebrovascular accident (CVA).
• Hemiplegia, resulting from CVA, often leads to shoulder dysfunction.
• Understanding the causes and prevalence of shoulder pain in hemiplegia is crucial for effective management.

Purpose of the Study:

• To investigate the incidence and characteristics of shoulder pain in patients with hemiplegia.
• To identify factors influencing shoulder pain, including spasticity, flaccidity, subluxation, and reflex sympathetic dystrophy syndrome (RSD).
• To provide insights into the management of shoulder pain in hemiplegic patients.

Main Methods:

• A prospective study followed 219 hemiplegia patients for one year post-CVA.
• Patients were evaluated for shoulder pain, subluxation, spasticity, flaccidity, and RSD.
• Roentgen examinations were performed on all participants.

Main Results:

• 72% of patients experienced shoulder pain during recovery.
• Spastic hemiplegia patients had a significantly higher incidence of shoulder pain (85%) compared to flaccid patients (18%).
• Anteroinferior subluxation was the most common cause, followed by RSD, which was more prevalent in spastic cases.

Conclusions:

• Shoulder pain is highly prevalent in hemiplegia, especially with spasticity.
• Early intervention for subluxation and spasticity is recommended to manage shoulder pain effectively.
• Addressing subluxation in flaccid paralysis and combating spasticity are key to improving patient outcomes.