Prevalence, risk factor and outcome in middle-aged and elderly population affected by hemiplegic shoulder pain: An observational study

Abstract

BackgroundHemiplegic shoulder pain is the most common complication after stroke. It usually occurs during the critical period of stroke recovery and hinders the rehabilitation of upper extremity motor function. However, there are few studies on the risk factors, the development and prognosis of shoulder pain after stroke.ObjectivesThis study aimed to observe the prevalence of post-stroke shoulder pain in the middle-aged and elderly population, find out the risk factors for post-stroke shoulder pain, and explore its effect on stroke outcome.MethodsEligible patients with hemiplegic shoulder pain in the rehabilitation unit were recruited and followed up at 2 and 4 months. The basic clinical information including age, gender, hypertension and atrial fibrillation history, stroke types, stroke location was recorded. Range of motion for shoulder, glenohumeral subluxation, muscle tension, activity of daily living of upper limb were measured. Data from blood test and shoulder ultrasonography were collected.Results480 stroke patients were screened within 1 year, and 239 patients were included in the statistical analysis. The prevalence of hemiplegic shoulder pain was 55.6% (133/239) at admission, 59.4% (142/239) after 2 months, and 55.1% (130/236) after 4 months. We found that shoulder pain was more likely to occur in women, patients with large-area stroke, increased tension of biceps brachii or triceps brachii, subluxation and limited passive range of motion of the shoulder. And the ability of daily living of patients with shoulder pain was significantly lower than that of patients without shoulder pain. Shoulder ultrasonography showed that the most common lesion in patients with shoulder pain was supraspinatus tendon thickening, and the thickness of supraspinatus tendon in the hemiplegic side of patients with shoulder pain was significantly higher than that of unaffected side. In addition, the hospitalization rate of patients with shoulder pain after 2 months and 4 months was significantly higher than that without shoulder pain.ConclusionsHemiplegic shoulder pain has a high prevalence and can last for several months. Multiple risk factors are involved. Moreover, hemiplegic shoulder pain affects the readmission rate of patients. Therefore, we should pay more attention to this problem in our clinical work. The application of various means to relieve shoulder pain will be conducive to the recovery of upper limb motor function and shorten the in-hospital rehabilitation time.

Post-stroke pain and rehabilitation (case report)

“…и у 75% -в течение первого года после инсульта [41][42][43]. По данным недавно опубликованного исследования, проведенного Y. Li et al [44], среди 239 пациентов с инсультом, которые были госпитализированы в реабилитационное отделение и обследовались в течение одного года, распространенность гемиплегической боли в плече составила 55,6% (133/239) при поступлении, 59,4% (142/239) через 2 мес. и 55,1% (130/236) через 4 мес.…”

Changes in serum levels of pain mediators in hemiplegic shoulder pain

“…Hemiplegic shoulder pain (HSP), also known as poststroke shoulder pain, is one of the most common complications after stroke and often affects patients’ quality of life (Li et al., 2022 ). HSP usually occurs 2 or 3 months after stroke (Anwer & Alghadir, 2020 ).…”

“…Incidence rate of HSP varies from 10% to 20%, and its prevalence rate varies from 8% to 47% (Anwer & Alghadir, 2020 ; Menoux et al., 2019 ; Nadler et al., 2020 ; Zhang et al., 2021 ). The pathogenesis of HSP includes impaired motor control, altered activity of the peripheral or central nervous system, and soft tissue injury, which may occur independently or in concert (Li et al., 2022 ; Wilson & Chae, 2015 ). In clinical practice, HSP can be diagnosed by history, musculoskeletal examination, neurological examination, and imaging and can be treated by proper arm handling and positioning, exercise therapy, physical factor therapy, and medication (Dyer et al., 2020 ; Wilson & Chae, 2015 ).…”

Repetitive peripheral magnetic stimulation for preventing shoulder subluxation after stroke: a randomized controlled trial

“… 1 A recent study reported that 46 of 239 patients with stroke (19%) had shoulder subluxation. 2 Moreover, sustained elongation of the shoulder muscles and capsule or shoulder joint motion causes shoulder pain. 3 Patients with shoulder pain show worse functional prognoses and longer hospital stays than those without pain.…”