J Korean Acad Rehabil Med.  1997 Feb;21(1):30-35.

Shoulder Pain in the Hemiplegia: Causative Factors and Radiologic Finding

• Lee BW
• Kwon HK

Abstract

Shoulder pain is the one of the most frequent and serious complicatsion in hemiplegia, which impedes effective rehabilitation. A prospective study was performed to evaluate the shoulder pain, related causative factors and radiologic findings in 35 stroke patients. Triphasic bone scan and simple radiologic evaluation of shoulder were performed at the beginning of rehabilitation treatment. The degree of shoulder pain, spasticity, passive range of motion (ROM) and subluxation were evaluated weekly and followed up for at least 3 months. The incidence of shoulder pain was 62.9%(22/35). It developed in 5.7+/-.7 weeks after the onset of stroke. The muscle tone was increased slightly and mean modified Ashworth scale was 0.77+/-.69 at the onset of shoulder pain. The duration of flaccid stage was longer in patients with shoulder pain than in patients without shoulder pain. The degree of spasticity was inversely correlated well with shoulder pain(r=-0.43, P<0.05). The shoulder pain was also correlated well with the degree of uptake in triphasic bone scan(r=0.61, P<0.05). The more limited ROM of shoulder presented, the more severe pain was. However, there was no relationship between shoulder pain and the degree of subluxation. Therefore, a special precaution is needed to prevent shoulder pain in flaccid stage and the triphasic bone is a useful study in predicting shoulder pain in hemiplegic patients.

Keyword

Hemiplegia; Shoulder pain; Triphasic bone scan; Muscle tone; ROM

MeSH Terms

Hemiplegia*
Humans
Incidence
Muscle Spasticity
Prospective Studies
Range of Motion, Articular
Rehabilitation
Shoulder Pain*
Shoulder*
Stroke