Shoulder Pain in Patients With Stroke

Yıl 2023, , 248 - 255, 07.08.2023

Basak Cigdem Karacay

https://doi.org/10.46332/aemj.1184921

Öz

Stroke is one of the most common causes of long-term disability in adults. Prevalence of hemiplegic shoulder pain; it is approximately 22-23% in the general population who have had a stroke. It has been evaluated as approximately 54-55% in rehabilitated stroke patients. One of the aims of rehabilitation in the management of stroke patients is to determine the etiology of shoulder pain, to increase functionality and pain control with correct diagnosis and effective intervention. In the literature on the management of hemiplegic shoulder pain, publications on injections and complementary medicine methods have been increasing rapidly. In current meta-analyses, suprascapular nerve injections are recommended for the management of acute hemilegic shoulder pain and increasing the range of motion of the joint. It has been reported that pain and joint range of motion improve with botulinum toxin injections and this effect persists in the long term. Studies on acupuncture, dry needling, and neuromuscular taping, which are complementary medicine methods, have been conducted in patients with hemiplegic shoulder pain. This review covers the epidemiology and diagnostic methods of shoulder pain in stroke patients and the approach to hemiplegic shoulder pain in the light of current literature.

Anahtar Kelimeler

hemiplegic shoulder pain, stroke, rehabilitation, review, pain

Destekleyen Kurum

none

Proje Numarası

none

İnmeli Hastada Omuz Ağrısına Yaklaşım

Öz

İnme yetişkinlerdeki uzun dönem dizabilitenin en sık nedenlerindendir. Hemiplejik omuz ağrısı prevalansı; inme geçiren genel popülasyonda yaklaşık %22-23’tür. Rehabilite edilen inme hastalarında ise yaklaşık %54-55 olarak değerlendirilmiştir. İnme hastalarının yönetiminde omuz ağrısı etyolojisinin belirlenmesi, doğru tanı ve etkili müdahale ile fonksiyonelliğin artırılması ve ağrı kontrolü rehabilitasyonun amaçlarındandır. Hemiplejik omuz ağrısının yönetimi ile ilgili literatürde son zamanda enjeksiyonlar, tamamlayıcı tıp yöntemleri ile ilgili yayınlar hızla artmaktadır. Güncel metanalizlerde akut dönem hemiplejik omuz ağrısı yönetimi ve eklem hareket açıklığının artırılmasında supraskapular sinir enjeksiyonları önerilmektedir. Botulinum toksin enjeksiyonları ile ağrı ve eklem hareket açıklığının iyileştiği ve bu etkinin uzun dönemde de sürdüğü bildirilmiştir. Hemiplejik omuz ağrılı hastalarda tamamlayıcı tıp yöntemlerinden akupunktur, kuru iğneleme, nöromüsküler bantlama uygulaması ile ilgili çalışmalar yapılmıştır. Bu derleme güncel literatür eşliğinde inmeli hastada omuz ağrısı epidemiyolojisi ve tanı yöntemleri ve hemiplejik omuz ağrısına yaklaşımı konu almaktadır.

Anahtar Kelimeler

hemiplejik omuz ağrısı, derleme, inme, ağrı, rehabilitasyon

Proje Numarası

none

Kaynakça

• 1. Vasudevan JM, Browne BJ. Hemiplegic shoulder pain: an approach to diagnosis and management. Phys Med Rehabil Clin N Am. 2014;25(2):411-437.
• 2. Kalichman L, Ratmansky M. Underlying pathology and associated factors of hemiplegic shoulder pain. Am J Phys Med Rehabil. 2011;90(9):768-780.
• 3. Adey-Wakeling Z, Liu E, Crotty M, et al. Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke: A Prospective Population-Based Study. Am J Phys Med Rehabil. 2016;95(10):758-763.
• 4. Coupar F, Pollock A, Rowe P, Weir C, Langhorne P. Predictors of upper limb recovery after stroke: a systematic review and meta-analysis. Clin Rehabil. 2012;26(4):291-313.
• 5. Tavora DG, Gama RL, Bomfim RC, Nakayama M, Silva CE. MRI findings in the painful hemiplegic shoulder. Clin Radiol. 2010;65(10):789-794.
• 6. Moosmayer S, Smith HJ, Tariq R, Larmo A. Prevalence and characteristics of asymptomatic tears of the rotator cuff: an ultrasonographic and clinical study. J Bone Joint Surg Br. 2009;91(2):196-200.
• 7. Gamble GE, Barberan E, Laasch HU, Bowsher D, Tyrrell PJ, Jones AK. Poststroke shoulder pain: a prospective study of the association and risk factors in 152 patients from a consecutive cohort of 205 patients presenting with stroke. Eur J Pain. 2002;6(6):467-474.
• 8. Roosink M, Renzenbrink GJ, Buitenweg JR, Van Dongen RT, Geurts AC, Ijzerman MJ. Somatosensory symptoms and signs and conditioned pain modulation in chronic post-stroke shoulder pain. J Pain. 2011;12(4):476-485.
• 9. Chae J. Poststroke complex regional pain syndrome. Top Stroke Rehabil. 2010;17(3):151-162.
• 10. Zeilig G, Rivel M, Weingarden H, Gaidoukov E, Defrin R. Hemiplegic shoulder pain: evidence of a neuropathic origin. Pain. 2013;154(2):263-271.
• 11. Wilson RD, Chae J. Hemiplegic Shoulder Pain. Phys Med Rehabil Clin N Am. 2015;26(4):641-655.
• 12. Murie-Fernandez M, Carmona Iragui M, Gnanakumar V, Meyer M, Foley N, Teasell R. Painful hemiplegic shoulder in stroke patients: causes and management. Neurologia. 2012;27(4):234-244.
• 13. Gilmore PE, Spaulding SJ, Vandervoort AA. Hemiplegic shoulder pain: implications for occupational therapy treatment. Can J Occup Ther. 2004;71(1):36-46.
• 14. Ada L, Foongchomcheay A, Canning C. Supportive devices for preventing and treating subluxation of the shoulder after stroke. Cochrane Database Syst Rev. 2005(1):CD003863.
• 15. Kim MS, Kim SH, Noh SE, Bang HJ, Lee KM. Robotic-Assisted Shoulder Rehabilitation Therapy Effectively Improved Poststroke Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2019;100(6):1015-1022.
• 16. Takebayashi T, Takahashi K, Amano S, et al. Robot-Assisted Training as Self-Training for Upper-Limb Hemiplegia in Chronic Stroke: A Randomized Controlled Trial. Stroke. 2022;53(7):2182-2191.
• 17. Price CI, Pandyan AD. Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review. Clin Rehabil. 2001;15(1):5-19.
• 18. Suriya-amarit D, Gaogasigam C, Siriphorn A, Boonyong S. Effect of interferential current stimulation in management of hemiplegic shoulder pain. Arch Phys Med Rehabil. 2014;95(8):1441-1446.
• 19. Yelnik AP, Colle FM, Bonan IV, Vicaut E. Treatment of shoulder pain in spastic hemiplegia by reducing spasticity of the subscapular muscle: a randomised, double blind, placebo controlled study of botulinum toxin A. J Neurol Neurosurg Psychiatry. 2007;78(8): 845-848.
• 20. Kong KH, Neo JJ, Chua KS. A randomized controlled study of botulinum toxin A in the treatment of hemiplegic shoulder pain associated with spasticity. Clin Rehabil. 2007;21(1):28-35.
• 21. Xie HM, Guo TT, Sun X, et al. Effectiveness of Botulinum Toxin A in Treatment of Hemiplegic Shoulder Pain: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2021;102(9):1775-1787.
• 22. Marciniak CM, Harvey RL, Gagnon CM, et al. Does botulinum toxin type A decrease pain and lessen disability in hemiplegic survivors of stroke with shoulder pain and spasticity?: a randomized, double-blind, placebo-controlled trial. Am J Phys Med Rehabil. 2012;91(12):1007-1019.
• 23. Dekker JH, Wagenaar RC, Lankhorst GJ, de Jong BA. The painful hemiplegic shoulder: effects of intra-articular triamcinolone acetonide. Am J Phys Med Rehabil. 1997;76(1):43-48.
• 24. Snels IA, Beckerman H, Twisk JW, et al. Effect of triamcinolone acetonide injections on hemiplegic shoulder pain: A randomized clinical trial. Stroke. 2000;31(10):2396-2401.
• 25. Tao W, Fu Y, Hai-Xin S, Yan D, Jian-Hua L. The application of sonography in shoulder pain evaluation and injection treatment after stroke: a systematic review. J Phys Ther Sci. 2015;27(9):3007-3010.
• 26. Allen ZA, Shanahan EM, Crotty M. Does suprascapular nerve block reduce shoulder pain following stroke: a double-blind randomised controlled trial with masked outcome assessment. BMC Neurol. 2010;10(1):1-5.
• 27. Yasar E, Vural D, Safaz I, et al. Which treatment approach is better for hemiplegic shoulder pain in stroke patients: intra-articular steroid or suprascapular nerve block? A randomized controlled trial. Clin Rehabil. 2011;25(1):60-68.
• 28. Chiu YH, Chang KV, Wu WT, Hsu PC, Özçakar L. Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis. Pharmaceuticals (Basel). 2021;14(8):788.
• 29. De Sire A, Moggio L, Demeco A, et al. Efficacy of rehabilitative techniques in reducing hemiplegic shoulder pain in stroke: Systematic review and meta-analysis. Ann Phys Rehabil Med. 2022;65(5):101602.
• 30. Lee JA, Park SW, Hwang PW, et al. Acupuncture for shoulder pain after stroke: a systematic review. J Altern Complement Med. 2012;18(9):818-823.
• 31. Serrezuela RR, Quezada MT, Zayas MH, Pedrón AM, Hermosilla DM, Zamora RS. Robotic therapy for the hemiplegic shoulder pain: a pilot study. J Neuroeng Rehabil. 2020;17(1):54.
• 32. Kim MS, Kim SH, Noh SE, Bang HJ, Lee KM. Robotic-Assisted Shoulder Rehabilitation Therapy Effectively Improved Poststroke Hemiplegic Shoulder Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2019;100(6):1015-1022.