Hemiplegic Shoulder Pain – A Case Report

Authors

  • Dr. Victoria Kuttan
  • Dr. Deepak Anap

DOI:

https://doi.org/10.46858/dvvpf.j.

Keywords:

Hemiplegia, Shoulder pain, Physiotherapy, VAS, DASH Score

Abstract

Shoulder pain due to hemiplegia is one of the common consequence following stroke. Pain in the shoulder joint negatively affects the mobility, transfers and performing Activity of daily living (ADL’s) and the effective use of hand. The  main cause of pain which is impingement due to altered scapula-humeral kinematics. If shoulder pain is not approached at the right phase of rehabilitation can lead to rotator cuff tear in an already weakened upper extremity, thereby will hamper the function to a great extent. Thus in this single case study of a 70 year old patient 4 months post stroke a structured goal directed physiotherapy intervention approaches were administered. These interventions mainly emphasized on treating the cause mainly the pain due to impingement of sub-acromial structures, restricted joint mobility due to capsular adhesion and rotator cuff muscle weakness and altered kinetics and kinematics at the shoulder complex. Intervention led to more than 30% of change for reduction in pain improvement in Range of motion (ROM)decreased muscle tightness and improved muscle flexibility.

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References

Coskun Benlidayi I, Basaran S. Hemiplegic shoulder pain: A common clinical consequence of stroke. Pract Neurol 2014;14:88-91.

Magarey ME, Jones MA. Dynamic evaluation and early management of altered motor control around the shoulder complex. Man Ther 2003;8:195-206

Coskun Benlidayi I, Basaran S. Hemiplegic shoulder pain: A common clinical consequence of stroke. Pract Neurol 2014;14:88-91

Vuagnat H, Chantraine A. Shoulder pain in hemiplegia revisited: Contribution of functional electrical stimulation and other therapies. J Rehabil Med 2003;35:49 54.

Pain Carlsson AM: Assessment of chronic pain. I. Aspects of reliability and validity of the visual analogue scale. Pain 1983;16:87-101.

Norkin CC, White DJ. Measurement of joint motion: a guide to goniometry. FA Davis; 2016 Nov 18.

Finley M, Goodstadt N, Soler D, Somerville K, Friedman Z, Ebaugh D. Reliability and validity of active and passive pectoralis minor muscle length measures. Brazilian journal of physical therapy. 2017 May 1;21(3):212-8.

Dalton E, Lannin NA, Laver K, Ross L, Ashford S, McCluskey A, Cusick A. Validity, reliability and ease of use of the disabilities of arm, shoulder and hand questionnaire in adults following stroke. Disability and rehabilitation. 2017 Nov 20;39(24):2504-11.

Scott F. Nadler, DO, FACSM, Kurt Weingand, PhD, DVM, and Roger J. Kruse, MD; The Physiologic Basis and Clinical Applications of Cryotherapy and Thermotherapy for the Pain Practitioner, pain physician, 2004.

Hengeveld, E, and Banks, K: Maitland’s Peripheral Manipulation, ed. 4. Oxford: Butterworth Heinemann, 2005.

Hing W, Hall T, Rivett DA, Vicenzino B, Mulligan B. The Mulligan Concept of Manual Therapy-eBook: Textbook of Techniques. Elsevier Health Sciences; 2015 Jun 22.

McClure P, Balaicuis J, Heiland D, Broersma ME, Thorndike CK, Wood A. A randomized controlled comparison of stretching procedures for posterior shoulder tightness. journal of orthopaedic & sports physical therapy. 2007 Mar;37(3):108-14.

Bobath concept, Theory and clinical practice in neurological rehabilitation

Moezy A, Sepehrifar S, Dodaran MS. The effects of scapular stabilization based exercise therapy on pain, posture, flexibility and shoulder mobility in patients with shoulder impingement syndrome: a controlled randomized clinical trial. Medical journal of the Islamic Republic of Iran. 2014;28:87.

Chitra J, Joshi D. Effect of scapular hold-relax technique on shoulder pain in hemiplegic subjects: A randomized controlled trial. Physiotherapy-The Journal of Indian Association of Physiotherapists. 2017 Jul 1;11(2):49.

Forster A, Clayton EB, Palastanga N. Clayton's electrotherapy: theory and practice. Bailli?e Tindall; 1985.

Swain DP, Brawner CA, American College of Sports Medicine. ACSM's resource manual for guidelines for exercise testing and prescription. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014.

Phys Ther 59(8):988–995, 1979. Warwick, R, and Williams, S (eds): Arthrology. In Gray’sAnatomy, 35th British ed. Philadelphia: WB Saunders, 1973.

Van der Wees PJ, Lenssen AF, Hendriks EJ, Stomp DJ, Dekker J, de Bie RA. Effectiveness of exercise therapy and manual mobilisation in ankle sprain and functional instability: a systematic review. Aust J Physiother. 2006;52:27–37.

Hindle KB, Whitcomb TJ, Briggs WO, Hong J. Proprioceptive neuromuscular facilitation (PNF): Its mechanisms and effects on range of motion and muscular function. J Hum Kinet 2012;31:105 13

21 Qiu H, Li J, Zhou T, Wang H, Li J. Electrical Stimulation in the Treatment of Hemiplegic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials. American journal of physical medicine & rehabilitation. 2019 Apr 1;98(4):280-6.

Gonçalves RL, Suzuki ID, Sanchez FF, De Leon EB, de Oliveira Andrade PM. Effects of Aerobic Conditioning on Individuals Post-Stroke: What Is the Evidence?. International Journal of Clinical Medicine. 2016 Mar 8;7(03):245.

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Published

2019-12-11

How to Cite

Dr. Victoria Kuttan, & Dr. Deepak Anap. (2019). Hemiplegic Shoulder Pain – A Case Report. VIMS Health Science Journal, 6(4), 105–109. https://doi.org/10.46858/dvvpf.j.

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Section

Case Report