Shoulder pain after stroke: a review of the evidence base to inform the development of an integrated care pathway

Turner-Stokes, Lynne; Jackson, Diana

doi:10.1191/0269215502cr491oa

Cited by 234 publications

(201 citation statements)

References 75 publications

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“…1,2 The prevalence of shoulder pain relative to the degree of paralysis ranges from 16% to 84%. 3 Over 70% of stroke patients experience significant shoulder pain.…”

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confidence: 99%

“…4 Shoulder pain after stroke has been connected with contracture of the shoulder, glenohumeral subluxation, injury of the axillary nerve, rupture of the rotator cuff, and spasticity of shoulder muscles, and it is associated with poor motor recovery. 2 Therefore, it is very important for stroke patients to treat shoulder pain properly. For good motor recovery, various treatments have been suggested, including electrical stimulation, ultrasound, acupuncture, herbal medicine, exercise, taping, and physical therapy.…”

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confidence: 99%

“…It is thought that acupuncture works by releasing chemical compounds in the body that relieve pain, by overriding pain signals in the nerves, or by allowing energy (qi) or blood to flow freely through the body. 2 Although the exact mechanism of this treatment remains unclear, it is apparent that reproducible neurological and chemical changes occur in response to acupuncture, and that these changes almost certainly modify the response to perception of pain. 24 Even though this review has provided many positive conclusions, there are also several limitations.…”

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confidence: 99%

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Acupuncture for Shoulder Pain After Stroke: A Systematic Review

Lee

Park

Hwang

et al. 2012

The Journal of Alternative and Complementary Medicine

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Objectives: Shoulder pain, for which acupuncture has been used, is a common complication after a stroke that interferes with the function of the upper extremities. The aim of this systematic review is to summarize and evaluate the effects of acupuncture for shoulder pain after stroke. Methods: Randomized controlled trials (RCTs) involving the effects of acupuncture for shoulder pain, published between

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“…1,2 The prevalence of shoulder pain relative to the degree of paralysis ranges from 16% to 84%. 3 Over 70% of stroke patients experience significant shoulder pain.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Acupuncture for Shoulder Pain After Stroke: A Systematic Review

Lee

Park

Hwang

et al. 2012

The Journal of Alternative and Complementary Medicine

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“…Shoulder pain after stroke is significantly related to reduction in satisfaction with life 6,30,31) , and range of motion of shoulder external rotation is related to upper extremity function 3,8) . Regardless of the direction of the upper extremity, the humeral head needs minimal subacromial space lest it should impinge against the glenoid fossa.…”

Section: Discussionmentioning

confidence: 99%

A Study of the Clinical Utility of the BPI-12 and 23 in Predicting Shoulder Pain in Stroke Patients

Lee

Kim

2012

J Phys Ther Sci

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Abstract. [Purpose] This study was designed to evaluate the clinical utility of the Brief Pain Inventory-12, 23 (BPI-12, 23) for predicting shoulder pain in stroke patients and to compare the functional ability of the BPI-12, 23 test to discriminate between subgroups with and without shoulder pain.[Subjects] The subjects were 62 persons who were chronic stroke survivors with shoulder pain.[Methods] The patients answered questions on shoulder pain using the BPI question 12 (BP1-12) and Pain-related Quality of life (BPI-23). Therapists measured the performance of combined upper-limb movements including the hand behind the neck (HBN) maneuver, and added passive painfree shoulder external rotation range of motion, and the Modified Ashworth Scale (MAS) score of the elbow flexors. [Conclusion] The BPI-12 and 23 both have potential as screening tools for risk factors of shoulder pain. They can be performed during evaluation to increase the likelihood of determining those who complain of hemiplegic shoulder pain after stroke. However they first require confirmation in a prospective study.

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“…Subluxation is difficult to define, 41 and its measurement is unreliable and often of no clinical significance. 12 There is no validated measure of upper limb spasticity other than at the elbow.…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial to Evaluate the Effect of Surface Neuromuscular Electrical Stimulation to the Shoulder After Acute Stroke

Church

Price

Pandyan

et al. 2006

Stroke

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Background and Purpose— Surface neuromuscular electrical stimulation (sNMES) after stroke aims to improve upper limb function and reduce shoulder pain, but current evidence of effectiveness is inconclusive. We have undertaken a randomized controlled trial to evaluate sNMES to the shoulder after acute stroke. Methods— One hundred seventy-six patients, within 10 days of stroke onset, were randomized to receive sNMES or placebo in addition to stroke unit care. The primary outcome measure was upper limb function measured by the Action Research Arm Test (ARAT) 3 months after stroke. Secondary outcome measures included other measures of upper limb function, upper limb impairment, pain, disability, and global health status. Outcome assessments were blinded. Results— There was no difference in arm function between groups in terms of the primary outcome measure. The median ARAT at 3 months was 50 in the intervention group and 55.5 in the control group ( P =0.068). Significant differences were seen at 3 months in favor of the control group for other measures of arm function and impairment: grasp and gross movement subsections of the ARAT, Frenchay Arm Test, and the arm subsection of the Motricity Index. Secondary analysis suggested that these differences were most marked in subjects with severe initial upper limb weakness. Conclusions— A 4-week program of sNMES to the shoulder after acute stroke does not improve functional outcome and may worsen arm function in severely impaired stroke patients. “Routine” use of sNMES to the proximal affected upper limb after acute stroke cannot be recommended.

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Shoulder pain after stroke: a review of the evidence base to inform the development of an integrated care pathway

Cited by 234 publications

References 75 publications

Acupuncture for Shoulder Pain After Stroke: A Systematic Review

Acupuncture for Shoulder Pain After Stroke: A Systematic Review

A Study of the Clinical Utility of the BPI-12 and 23 in Predicting Shoulder Pain in Stroke Patients

Randomized Controlled Trial to Evaluate the Effect of Surface Neuromuscular Electrical Stimulation to the Shoulder After Acute Stroke

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