Murie-Fernandez M, Carmona Iragui M, Gnanakumar V, Meyer M, Foley N, Teasell R. Hombro doloroso hemipléjico en pacientes con ictus: causas y manejo. Neurologia 2012 May;27(4):234-244.
The hemiplegic shoulder pain is common after a stroke. Its
appearance brings pain and limits daily living activities as well as
participation in specific Neuro-rehabilitation programs. All this leads to a
worse functional outcome. Good management of patients can reduce both the
frequency and intensity of shoulder pain, improving functional outcome.
DEVELOPMENT: We conducted a literature search of various databases between 1980
and 2008. The articles were evaluated using the PEDro scoring system. Five
evidence levels were established for the conclusions. CONCLUSIONS: Shoulder
subluxation, occurs at an early stage after stroke and is associated with
subluxation of the shoulder joint and spasticity (mainly subscapularis and
pectoralis). Slings prevent subluxation of the shoulder. It is preferable to move
within a lower range of motion and without aggression to prevent the occurrence
of shoulder pain. The injection of corticosteroids does not improve pain and
range of motion in hemiplegic patients, while botulinum toxin combined with
physical therapy appears to reduce hemiplegic shoulder pain.