Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke

Adey‐Wakeling, Zoe; Liu, Enwu; Crotty, Maria; Leyden, James; Kleinig, Timothy; Anderson, Craig S.; Newbury, Jonathon

doi:10.1097/phm.0000000000000496

Cited by 45 publications

(40 citation statements)

References 23 publications

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“…The experience of pain limits stroke survivors’ range of motion (ROM) and motor functioning of the affected shoulder ( 9 ). It also impairs their ability to participate in daily or social activities and further compromises their health-related quality of life ( 10 ). More importantly, stroke survivors may have poorer motivation to pursue rehabilitation training due to intolerable pain, which, in turn, may have a negative effect on their recovery outcomes ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review

Chau

et al. 2018

Front. Neurol.

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BackgroundPoststroke shoulder pain limits stroke survivors’ physical functioning, impairs their ability to perform daily activities, and compromises their quality of life. The use of acupuncture to manage shoulder pain after a stroke is believed to free the blockage of energy flow and produce analgesic effects, but the evidence is unclear. We therefore conducted a systematic review to summarize the current evidence on the effects of acupuncture on the recovery outcomes of stroke survivors with shoulder pain.MethodsFourteen English and Chinese databases were searched for data from January 2009 to August 2017. The review included adult participants with a clinical diagnosis of ischemic or hemorrhagic stroke who had developed shoulder pain and had undergone conventional acupuncture, electroacupuncture, fire needle acupuncture, or warm needle acupuncture. The participants in the comparison group received the usual stroke care only.ResultsTwenty-nine randomized controlled trials were included. Most studies were assessed as having a substantial risk of bias. Moreover, due to the high heterogeneity of the acupuncture therapies examined, pooling the results in a meta-analysis was not appropriate. A narrative summary of the results is thus presented. The review showed that conventional acupuncture can be associated with benefits in reducing pain and edema and improving upper extremity function and physical function. The effects of conventional acupuncture on improving shoulder range of motion (ROM) are in doubt because this outcome was only examined in two trials. Electroacupuncture might be effective in reducing shoulder pain and improving upper extremity function, and conclusions on the effects of electroacupuncture on edema, shoulder ROM, and physical function cannot be drawn due to the limited number of eligible trials. The evidence to support the use of fire needle or warm needle acupuncture in stroke survivors with shoulder pain is also inconclusive due to the limited number of studies.ConclusionAlthough most studies reviewed concluded that conventional and electroacupuncture could be effective for management of shoulder pain after stroke, the very high potential for bias should be considered. Further work in this area is needed that employs standardized acupuncture treatment modalities, endpoint assessments, and blinding of treatments.

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Section: Introductionmentioning

confidence: 99%

Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review

Chau

et al. 2018

Front. Neurol.

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“…It is associated with an increased length of stay during inpatient rehabilitation and is an important predictor of poor functional outcome in the upper limb [4,5]. It has been shown to be significantly associated with reduced quality of life at 12 months post-stroke [6], as well as impacting on a patient's mood, activities of daily living and participation in leisure activities to a great extent [7].…”

Section: Introductionmentioning

confidence: 99%

A survey of the current practice of intramuscular Botulinum toxin injections for hemiplegic shoulder pain in the UK

Holmes

Connell

2017

Disability and Rehabilitation

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Current UK practice of Botulinum Toxin type A injections for hemiplegic shoulder pain associated with spasticity is highly variable. There are large gaps between current practice and available evidence with regards to muscle selection and doses used. A number of areas for further investigation have been identified to progress current understanding of this intervention. Implications for rehabilitation There are wide variations in practice for this complex intervention and clinicians should consider that their individual decision-making could be based on their own beliefs rather than available evidence. Pectoralis major is most commonly injected to treat hemiplegic shoulder pain, but further evaluation is required to address whether it is the most effective. Clinicians most often use a limitation of shoulder abduction and external rotation, flexor patterning of the upper limb, and pain on passive movement to identify when hemiplegic shoulder pain is due to spasticity over other causes. Further research is needed to identify which patients are most likely to benefit from this intervention and at what stage post-stroke its use is most optimal.

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“…1 HSP is associated with poor rehabilitation outcomes, including interference with activities of daily living (ADLs) 2 and poor quality of life (QoL). 3 Unfortunately, many who develop HSP do not find relief with current standard of care. 1 There is a need for better treatment options for those with HSP.…”

Section: Introductionmentioning

confidence: 99%

Fully Implantable Peripheral Nerve Stimulation for Hemiplegic Shoulder Pain: A Multi-Site Case Series With Two-Year Follow-Up

Wilson

Bennett

Nguyen

et al. 2018

Neuromodulation: Technology at the Neural Interface

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Hemiplegic Shoulder Pain Reduces Quality of Life After Acute Stroke

Cited by 45 publications

References 23 publications

Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review

Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review

A survey of the current practice of intramuscular Botulinum toxin injections for hemiplegic shoulder pain in the UK

Fully Implantable Peripheral Nerve Stimulation for Hemiplegic Shoulder Pain: A Multi-Site Case Series With Two-Year Follow-Up

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