Incidence, Prevalence, and Risk Factors of Hemiplegic Shoulder Pain: A Systematic Review

Abstract

<jats:p>The current systematic review aimed to investigate the incidence, prevalence, and risk factors causing hemiplegic shoulder pain (HSP) after stroke. Two independent authors screened titles and abstracts for the eligibility of the included studies in the electronic databases PubMed and Web of Science. Studies which reported the incidence, prevalence, and risk factors of HSP following stroke were included. The included studies were assessed using the Newcastle–Ottawa Scale for evaluating the quality of nonrandomized studies in meta-analyses. Eighteen studies were included in the final synthesis. In all studies, the number of patients ranged between 58 and 608, with the mean age ranging from 58.7 to 76 years. Seven included studies were rated as “good “quality, while one study rated “fair” and 10 studies rated “poor” quality. Eight studies reported incidence rate while 11 studies reported the prevalence of HSP following a stroke. The incidence of HSP was ranging from 10 to 22% in the metanalysis of the included studies. The prevalence of HSP was ranging from 22 to 47% in the metanalysis of the included studies. The most significant predictors of HSP were age, female gender, increased tone, sensory impairment, left-sided hemiparesis, hemorrhagic stroke, hemispatial neglect, positive past medical history, and poor National Institutes of Health Stroke Scale score. The incidence and prevalence of HSP after stroke vary considerably due to various factors. Knowledge of predictors is important to minimize the risk of developing HSP following a stroke.</jats:p>

Incidence and Prevalence of Poststroke Shoulder Pain Among Different Regions of the World: A Systematic Review and Meta-Analysis

“…In addition, based on the available evidence, we also found that the incidence and prevalence of PSSP were similar in men and women, while the incidence and prevalence of right-sided hemiplegia were higher in men. Contrary to the results reported by Anwer et al ( 49 ), some included studies ( 23 , 25 – 27 , 31 ) showed that patients with right-sided hemiplegia were more likely to have PSSP, possibly because of different included populations. There seemed to be three main etiological groups that may cause PSSP, namely central post-stroke pain, complex regional pain syndrome, and musculoskeletal pain (spasticity-related pain, shoulder subluxation induced pain, etc.)…”

“…(50,51). Similarly, many different risk factors for PSSP have also been found (49,52). Further understanding of the etiology and risk factors of PSSP is important to minimize the risk of developing shoulder pain following a stroke.…”

<p>Interventions for Post-Stroke Shoulder Pain: An Overview of Systematic Reviews</p>

“…Shoulder pain is a common debilitating problem after stroke, with a recent metaanalysis indicating an incidence of 10%-22%. 1 There appear to be three major etiological groups that may present with hemiplegic shoulder pain (HSP), 2 namely central (central post-stroke pain, CPSP), regional (chronic regional pain syndrome, CRPS, or reflex sympathetic dystrophy, RSD), and local mechanical pain. 3 The causes of the HSP are numerous, and often overlapping.…”

Presentation_2.zip

“…In addition, based on the available evidence, we also found that the incidence and prevalence of PSSP were similar in men and women, while the incidence and prevalence of rightsided hemiplegia were higher in men. Contrary to the results reported by Anwer et al (49), some included studies (23,(25)(26)(27)31) showed that patients with right-sided hemiplegia were more likely to have PSSP, possibly because of different included populations. There seemed to be three main etiological groups that may cause PSSP, namely central post-stroke pain, complex regional pain syndrome, and musculoskeletal pain (spasticityrelated pain, shoulder subluxation induced pain, etc.)…”