Hemiplegic Shoulder Pain in People with Stroke: Present and the Future

Kumar, Praveen

doi:10.2217/pmt-2018-0075

Cited by 33 publications

(27 citation statements)

References 25 publications

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“…Shoulder pain is a frequent consequence of stroke that leads to reduced function of the upper limb and limited performance in activities of the individual's daily life. The prevalence of shoulder pain among stroke survivors varies from 30 to 65% ( 6 ). This condition is more common from the 2nd month after stroke on and may disappear spontaneously in some cases or persist in 65% of the patients, for 12 months or more ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

To Combine or Not to Combine Physical Therapy With tDCS for Stroke With Shoulder Pain? Analysis From a Combination Randomized Clinical Trial for Rehabilitation of Painful Shoulder in Stroke

et al. 2021

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Purpose: Transcranial Direct Current Stimulation (tDCS) is an intervention that seems to be an ideal tool to enhance the effects of rehabilitation therapies given it facilitates generation of plasticity in the stimulated brain area. In stroke this strategy has been highly utilized; however, the results have been mixed. In this trial we have evaluated the analgesic and functional effects of Transcranial Direct Current Stimulation (tDCS) combined with physiotherapy in stroke survivors with shoulder pain.Methods: Twenty-six stroke surviving adults with shoulder pain received 10 sessions of passive mobilization and performed upper limb exercises using a cycle ergometer, combined with active or sham tDCS. The intensity of pain in the hemiplegic shoulder was measured using the Visual Analog Scale (VAS); secondary outcomes were the level of motor impairment, handgrip strength, range of motion, motor function of the upper limbs, and quality of life (QOL) assessed before and after 10 sessions and 1 month after the end of the treatment.Results: A clinically important pain reduction (3 points) was found in both groups and was maintained at follow-up; there was no significant difference between groups (p = 0.3). Similarly, the shoulder range of motion improved, motor function and quality of life improved showed no significant differences between groups. One result that needs to be underscored is that both groups had a significant effect size toward improvement in all of these outcomes.Conclusions: We discuss in this study that tDCS is not a useful combination strategy when the physical therapy has a large effect by itself and we also review other negative trials of combined therapy under this framework of ceiling effect of the main physical therapy.Trial registry: Trial registration: Brazilian Registry of Clinical Trials, RBR-8F5MNY (http://www.ensaiosclinicos.gov.br/rg/RBR-8f5mny/). Registered on June 2, 2017.Beginning of the recruitment of the volunteers: august, 2017.

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Section: Introductionmentioning

confidence: 99%

To Combine or Not to Combine Physical Therapy With tDCS for Stroke With Shoulder Pain? Analysis From a Combination Randomized Clinical Trial for Rehabilitation of Painful Shoulder in Stroke

et al. 2021

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“…In a cross-sectional study of 50 post-stroke individuals with shoulder pain, active myofascial trigger points were documented in up to 50% of the examined infraspinatus muscles [ 51 ], while other muscles were less often affected by MPS (supraspinatus 34%, teres minor 12%, and upper trapezius 20%). Weakness, rigidity, and adhesive capsulitis have all been implicated in the development of post-stroke shoulder pain [ 52 ], often accompanied by MPS of the subscapularis and other shoulder girdle muscles [ 53 , 54 ]. In another observational study, de Oliveira et al examined 40 patients with central post-stroke pain, observing MPS in 67.5% of them [ 55 ].…”

Section: Methodsmentioning

confidence: 99%

The Case for Comorbid Myofascial Pain—A Qualitative Review

Vulfsons

Minerbi

2020

IJERPH

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Myofascial pain syndrome is widely considered to be among the most prevalent pain conditions, both in the community and in specialized pain clinics. While myofascial pain often arises in otherwise healthy individuals, evidence is mounting that its prevalence may be even higher in individuals with various comorbidities. Comorbid myofascial pain has been observed in a wide variety of medical conditions, including malignant tumors, osteoarthritis, neurological conditions, and mental health conditions. Here, we review the evidence of comorbid myofascial pain and discuss the diagnostic and therapeutic implications of its recognition.

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“…by U Philpot and MI Johnson [5] and "A new way of thinking about pain," by JD Loeser [6]. As well as these, the most read Editorial of 2019 was "Hemiplegic shoulder pain in people with stroke: present and the future," provided by P Kumar [7].…”

Section: Content Highlights Of 2019mentioning

confidence: 99%

Welcome to the 10th Volume of Pain Management

Finnie

2020

Pain Manag.

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Hemiplegic Shoulder Pain in People with Stroke: Present and the Future

Cited by 33 publications

References 25 publications

To Combine or Not to Combine Physical Therapy With tDCS for Stroke With Shoulder Pain? Analysis From a Combination Randomized Clinical Trial for Rehabilitation of Painful Shoulder in Stroke

To Combine or Not to Combine Physical Therapy With tDCS for Stroke With Shoulder Pain? Analysis From a Combination Randomized Clinical Trial for Rehabilitation of Painful Shoulder in Stroke

The Case for Comorbid Myofascial Pain—A Qualitative Review

Welcome to the 10th Volume of Pain Management

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