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Arthrographic studies in painful hemiplegic shoulders
Archives of Physical Medicine and Rehabilitation
|May 1, 1984
Summary
Painful shoulder in hemiplegic patients is common. Studies suggest it resembles idiopathic frozen shoulder, not rotator cuff tears or spasticity, aiding targeted rehabilitation.
Area of Science:
- Neurology
- Orthopedics
- Rehabilitation Medicine
Background:
- Painful shoulder is a common complication in hemiplegic patients, prolonging rehabilitation.
- The exact cause of this shoulder pain is debated, and current treatments are not always effective.
Purpose of the Study:
- To investigate the etiology of painful, stiff shoulder joints in hemiplegic patients.
- To differentiate the cause from rotator cuff tears or spasticity.
Main Methods:
- Studied 30 hemiplegic patients with painful, stiff ipsilateral shoulders.
- Utilized shoulder arthrography and electromyography (EMG).
Main Results:
- Arthrography revealed capsular constriction (frozen shoulder) in 23 patients; 7 had normal arthrograms.
- No rotator cuff or capsular tears were identified.
- EMG showed electrical silence in shoulder muscles at rest, ruling out spasticity.
Conclusions:
- Post-hemiplegia painful shoulder is likely not due to rotator cuff tears or spasticity.
- The pathogenesis appears similar to idiopathic frozen shoulder (adhesive capsulitis).