Painful hemiplegic shoulder

BACKGROUND: Hemiplegic shoulder pain (HSP) is a common morbidity of stroke. Different treatment modalities can be used for optimizing the results and limiting the possible side effects. This research compares the effects of two therapies used to reduce the pain and improve the quality of life of the patients with HSP. OBJECTIVE: This study aimed to compare the effects of transcutaneous electrical nerve stimulation (TENS) and suprascapular nerve blockage (SSNB) in patients with HSP...

INTRODUCTION: Several theoretical frameworks currently promote the evidence-based clinical practice. One of these is Promoting Action on Research Implementation in Health Services (PARIHS) framework. However, The PARIHS framework emphasizes the use and implementation of pre-existing knowledge. This study aims to integrate of PARIHS conceptual framework to categorize evidence, context, and facilitation elements for the successful implementation of evidence-based painful hemiplegic shoulder (PHS) rehabilitation...

The relationship between hemiplegic shoulder pain (HSP) and subluxation is unclear. This study aimed to determine the differences of magnetic resonance imaging (MRI) findings in HSP patients with or without subluxation after stroke, and to analyze the etiology of shoulder pain. This retrospective study included 53 patients with HSP after stroke from September 2013 to February 2020. Patients underwent MRI of the shoulder because of shoulder pain. Clinical characteristics, including age, sex, stroke duration, body mass index, stroke type, visual analog scale score, Brunnstrom stage, and MRI arthrography findings of the affected shoulder, were recorded...

Cardiovascular disease affects close to half of the United States population and many of these patients will develop chronic pain syndromes as a result of their disease process. This article provides an overview of several pain syndromes that result, directly or indirectly, from cardiovascular disease including peripheral arterial disease, angina, thoracic outlet syndrome, postamputation pain, complex regional pain syndrome, and poststroke pain. Psychological and medical comorbidities that affect the medical decision-making process in the treatment of chronic pain associated with cardiovascular disease are also discussed...

Purpose: The purpose of this study was to investigate the prevalence of post-stroke complex regional pain syndrome (CRPS) and to examine the characteristics of inactivity status of the upper limb in post-stroke CRPS patients. In addition, as a sub-analysis, the association between the upper limb inactivity status and pain intensity was investigated in post-stroke CRPS patients. Patients and Methods: This cross-sectional study included 102 patients with first-ever stroke between April 2019 and February 2020...

Stroke is a debilitating neurological disorder with hemiplegia as most common presentation. Hemiplegic shoulder pain (HSP) affects a large number of stroke survivors and is associated with significant morbidity and low quality of life (QoL). The etiology is multifactorial and therefore the management is multipronged. Traditionally, oral analgesics have been advised with physical therapy and intra-articular steroid injections. This narrative review discusses emerging treatment strategies for HSP. It focuses on four key new treatments; electric stimulation, the use of robotics, intraarticular injections of novel anti-inflammatory agents, and pulsed radiofrequency treatment...

BACKGROUND: Post-stroke shoulder pain (PSSP) is characterized by shoulder pain on the hemiplegic side, which can limit physical activity in patients with stroke. Acupuncture combined with rehabilitation training (AR) has been widely used in PSSP, but the evidence of its effectiveness is still unclear. OBJECTIVE: The study aimed to evaluate the effect and safety of AR vs. rehabilitation training (RT) alone on PSSP. METHODS: We searched PubMed, the Cochrane Library, the Chinese Biological Medicine Database (CBM), the Chinese Scientific Journal Database (VIP), China National Knowledge Infrastructure (CNKI), and the WAN FANG database for relevant studies from their inception to February 2022...

BACKGROUND: Hemiplegic shoulder pain (HSP) is a common symptom for post-stroke patients, which has a severely adverse impact on their rehabilitation outcomes. However, the cause of HSP has not been clearly identified due to its complicated multifactorial etiologies. As possible causes of HSP, the abnormality of both muscular electrical activity and blood perfusion remains lack of investigations. OBJECTIVE: This study aimed to analyze the alteration of muscular electrical activity and blood perfusion of upper extremity in patients with HSP by using surface electromyography (sEMG) and laser speckle contrast imaging (LSCI) measurement techniques, which may provide some insight into the etiology of HSP...

OBJECTIVE: The development and validation of a nomogram for the individualized prediction of hemiplegic shoulder pain (HSP) during the inpatient rehabilitation of patients with stroke. DESIGN: Retrospective cohort study. SETTING: The rehabilitation department at a tertiary hospital. PARTICIPANTS: A total of 376 patients (N=376) with stroke admitted to inpatient rehabilitation from January 2018 to April 2021 were included in this study...

BACKGROUND: Hemiplegic shoulder pain (HSP) is common after stroke. The pain perception may exacerbate changes in the motor behavior of the ipsi-lesional upper limb, contributing to the functional decline of an individual's motor performance. OBJECTIVE: This study evaluates the influence of pain perception on the aiming movements performed with the ipsilesional upper limb in individuals with unilateral chronic stroke. METHODS: A cross-sectional study was conducted with 41 participants divided into three groups: 1) stroke with contralesional shoulder pain ≥ 3 by the Visual Numerical Pain Scale (SPSG; n = 13); 2) stroke no shoulder pain (nSPSG; n = 14); and 3) healthy control (CTG; n = 14) matched by sex and age...

The objective of this peripheral nerve stimulation consensus guideline is to add to the current family of consensus practice guidelines and incorporate a systematic review process. The published literature was searched from relevant electronic databases, including PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science from database inception to March 29, 2021. Inclusion criteria encompassed studies that described peripheral nerve stimulation in patients in terms of clinical outcomes for various pain conditions, physiological mechanism of action, surgical technique, technique of placement, and adverse events...

Background: Shoulder subluxation occurs in 17−64% of hemiplegic patients after stroke and develops mostly during the first three weeks of hemiplegia. A range of shoulder orthoses has been used in rehabilitation to prevent subluxation. However, there is little evidence of their efficacy. AIM: This study aimed to investigate whether there is a difference in the subluxation distance, pain, and functional level of the hemiplegic upper extremity among patients with two different shoulder orthoses. Design: This is a prospective, randomized controlled trial with intention-to-treat analysis...

The study objective was to determine the effect of long-duration neuromuscular electric stimulation (NMES) on shoulder subluxation and upper-extremity function during the acute post-stroke stage. Twenty-eight subjects (mean age ± standard deviation -70.0 ± 14.0 years) were randomly assigned to an experimental or to a control group receiving NMES to the supraspinatus and posterior deltoid muscles or sham treatment for 6 weeks. All the subjects continued standard rehabilitation and external shoulder support (EST)...

Background: Subacromial-subdeltoid (SASD) bursa and long head of the biceps tendon (LHBT) sheath corticosteroid injection are commonly used to treat shoulder pain associated with arthritic shoulder conditions, but effectiveness in the stroke population is unclear. This study aimed to investigate the clinical effectiveness of ultrasound-guided SASD bursa combined with LHBT sheath corticosteroid injection for hemiplegic shoulder pain (HSP) compared with SASD bursa injection alone. Methods: 60 patients with HSP were randomly allocated to the dual-target group ( n = 30) and single-target group ( n = 30)...

OBJECTIVES: To explore the effects of kinesiotaping in the treatment of shoulder pain and upper limb function in stroke survivors. METHODS: PubMed, EMBASE and the Cochrane Central Register of Controlled Trials were electronically and manually searched to identify relevant publications from inception to March 1, 2022. Full-text qualitative studies that explored the effects of kinesiotaping on hemiplegic shoulder pain and poststroke upper limb spasticity were included in the analysis...

BACKGROUND: Kinesiology tape (KT), a water-resistant and elastic tape which is well known measure for preventing musculoskeletal injuries, has recently gained popularity in neurological rehabilitation. This is a systematic and meta-analysis study, useful both to evaluate the efficacy of kinesiology taping on the functions of upper limbs in patients with stroke and to collect the main outcomes evaluated in the analyzed studies. METHODS: A comprehensive literature search of electronic databases including Medline, Web of science, Embase, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), WANFANG, and the China National Knowledge Infrastructure (CNKI)...

It is estimated that after stroke patients live 33% fewer remaining years compared with age- and sex-matched controls. Functional recovery after stroke depends on many factors, including age, functional status before stroke, stroke severity, and comorbidities. The purpose of rehabilitation services is to improve functional status. All patients with stroke should undergo a formal assessment of rehabilitation needs before hospital discharge. Types of rehabilitation include inpatient, subacute, and home health care...

Upper limb dysfunction after stroke is one of the most serious functional disorders, and adequate functional recovery is often not expected. Although various studies have been conducted on effective rehabilitation for upper limb dysfunction, active rehabilitation such as repetitive training of upper limb elevation has not been sufficiently conducted yet because the shoulder joint is highly unstable and the appearance of pain is easily observed. In this study, we performed right shoulder joint elevation training in a seated position using a single-joint hybrid assistive limb (HAL) in a 54-year-old female with right hemiplegia after a stroke...

BACKGROUND: Outpatient rehabilitation was temporarily suspended because of coronavirus disease (COVID-19), and there was a risk that patients' activities of daily living (ADLs) would decrease and physical functions unmaintained. Therefore, we investigated the ADLs and motor functions of chronic stroke patients whose outpatient rehabilitation was temporarily interrupted. METHODS: In this observational study, the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Barthel Index (BI) scores of 49 stroke hemiplegic patients at 6 and 3 months before rehabilitation interruptions were retrospectively determined and were prospectively investigated on resumption of outpatient rehabilitation...

OBJECTIVE: This study aimed to use multidimensional musculoskeletal ultrasound imaging technique to investigate the effect of electroacupuncture (EA) on shoulder subluxation in poststroke patients with hemiplegic shoulder pain. METHODS: In this prospective single-blind, randomized, sham-controlled study, thirty-four patients with shoulder subluxation and hemiplegic shoulder pain were recruited and randomly assigned into the EA group or the sham EA (SEA) group. In the EA group, EA was applied to the Jian yu (LI15), Bi nao (LI14), Jian zhen (SI9), and Jian liao (TE14) acupoints...