Efficacy of rehabilitative techniques in reducing hemiplegic shoulder pain in stroke: Systematic review and meta-analysis

Sire, Alessandro de; Moggio, Lucrezia; Demeco, Andrea; Fortunato, Francesco; Spanò, Riccardo; Aiello, Vincenzo; Marotta, Nicola; Ammendolia, Antonio

doi:10.1016/j.rehab.2021.101602

Cited by 28 publications

(19 citation statements)

References 63 publications

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“…In this complex scenario, several therapeutic approaches have been investigated and might be proposed to improve pain management in patients with chronic neuropathic pain, including mini-invasive interventions [ 22 , 66 , 67 , 68 ], pharmacological drugs [ 67 , 69 , 70 ], nutraceuticals [ 71 , 72 ], physical exercise [ 21 , 73 , 74 ] and instrumental rehabilitative techniques [ 20 , 75 ]. In addition, recent advances in understanding the pathophysiological mechanisms underpinning pain chronification reveals that specific peripheral [ 11 , 12 , 76 ] and central circuits might be involved [ 12 , 77 ].…”

Section: Discussionmentioning

confidence: 99%

Multidimensional Effectiveness of Botulinum Toxin in Neuropathic Pain: A Systematic Review of Randomized Clinical Trials

Lippi

Sire

Folli

et al. 2022

Toxins

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Although botulinum toxin (BoNT) has been suggested as a treatment to counter neuropathic pain, no previous systematic reviews investigated the multidimensional effects of BoNT on pain relief and Health-Related Quality of Life (HR-QoL). The aim of this systematic review is to summarize the current evidence on the effectiveness of BoNT treatment for neuropathic pain, and to characterize its multidimensional effectiveness in order to guide physicians in clinical practice. Five databases were systematically searched up to 4 April 2022, to identify randomized controlled trials satisfying the following criteria: adults suffering from neuropathic pain, BoNT administration, any comparator, multidimensional assessment of pain as primary outcome, HR-QoL, physical function, anxiety and depression, and sleep quality as secondary outcomes. Twelve studies were included. The multidimensional pain scales used were short-form McGill Pain Questionnaire, Neuropathic pain scale, Neuropathic Pain Symptom Inventory, International SCI Pain Basic Data Set, West Haven-Yale Multidimensional Pain Inventory, Brief Pain Inventory, and Douleur Neuropathique 4. These scales highlighted the positive effects of BoNT administration. According to the Jadad scale, all the RCTs included were high-quality studies. BoNT administration might be effectively introduced in the comprehensive management of neuropathic pain. Further research should focus on optimal and cost-effective therapeutic protocols.

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Section: Discussionmentioning

confidence: 99%

Multidimensional Effectiveness of Botulinum Toxin in Neuropathic Pain: A Systematic Review of Randomized Clinical Trials

Lippi

Sire

Folli

et al. 2022

Toxins

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“…Stroke is one of the leading causes of disability and mortality worldwide ( 1 , 2 ). The number of stroke patients is gradually increasing around the world, leading to increases in healthcare costs ( 3 ). Patients with stroke have various clinical conditions, including hemiparesis, loss of dexterity, functional limitations, gait disturbance, cognitive impairment, dysarthria, spasticity, neglect, and dysphagia ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundDysphagia is a common complication after stroke and is associated with the development of pneumonia. This study aimed to summarize the relationship between dysphagia and pneumonia in post-stroke patients.Materials and MethodsArticles published up to November 2021 were searched in the PubMed, Embase, Cochrane library, and Scopus databases. Studies that investigated the development of pneumonia in acute stroke patients with and without dysphagia were included. The methodological quality of individual studies was evaluated using the Risk Of Bias In Non-randomized Studies-of Interventions tool, and publication bias was evaluated using a funnel plot and Egger's test.ResultsOf 5,314 studies, five studies were included in the meta-analysis. The results revealed that the incidence of pneumonia was significantly higher in the dysphagia group than in the non-dysphagia group (OR 9.60; 95% CI 5.75–16.04; p < 0.0001; I2 = 78%). There was no significant difference in the mortality rate between the two groups (OR 5.64; 95% CI 0.83–38.18; p = 0.08; I2 = 99%).ConclusionDysphagia is a significant risk factor for pneumonia after stroke. The early diagnosis and treatment of dysphagia in stroke patients are important to prevent stroke-associated pneumonia.

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“…Shoulder subluxation appears in 15–81% of all patients post-stroke, often developing during the early post-stroke stage, defined as 6 months after the cerebral insult [ 1 , 2 , 3 ]. Subluxation may cause shoulder pain, severely impact upper-limb function, constrain the performance of activities of daily living, and negatively affect the rehabilitation process beyond the acute stage [ 2 , 3 , 4 , 5 , 6 ]. Subluxation should be treated as early as possible as it can worsen over time and develop into an uncorrectable state [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the management of this condition is believed to play an essential role in the rehabilitation process of patients post-stroke. Various approaches have been used to treat shoulder subluxation, i.e., anesthetic suprascapular nerve block, intramuscular injections of botulinum toxin, physical therapy, suprascapular nerve pulsed radiofrequency, corticosteroid injections, trigger-point dry needling, positioning, taping, mechanical supporting devices, and electrical stimulation [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study

Lavi

Elboim-Gabyzon

Naveh

et al. 2022

IJERPH

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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). Assessments were conducted pre- and post-intervention and at a 2 week follow-up session by an assessor blind to group allocation. Outcome measures included the degree of shoulder subluxation, Fugl–Meyer assessment-upper extremity (FMA-UE) test, FMA—hand and finger subscales, Functional Independence Measure (FIM), and shoulder pain (using the Numeric Pain Rate Scale). Shoulder subluxation was significantly lower, while the FMA-UE and FMA—hand and finger subscales were significantly improved in the experimental group post-intervention and at follow-up compared to the control group. FIM at follow-up improved more in the experimental group. No change was observed in pain level in both groups. Supplementing NMES to standard rehabilitation and EST is beneficial in reducing shoulder subluxation and improving upper-extremity function. Further research is necessary to determine effect of longer treatment duration and longer follow-up periods.

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Efficacy of rehabilitative techniques in reducing hemiplegic shoulder pain in stroke: Systematic review and meta-analysis

Cited by 28 publications

References 63 publications

Multidimensional Effectiveness of Botulinum Toxin in Neuropathic Pain: A Systematic Review of Randomized Clinical Trials

Multidimensional Effectiveness of Botulinum Toxin in Neuropathic Pain: A Systematic Review of Randomized Clinical Trials

The Relationship Between Dysphagia and Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

A Combination of Long-Duration Electrical Stimulation with External Shoulder Support during Routine Daily Activities in Patients with Post-Hemiplegic Shoulder Subluxation: A Randomized Controlled Study

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